BACKGROUND: Up to 20% of patients can have recurrence of adenomatous tissue at first surveillance study after colon endoscopic mucosal resection of large polyps. AIMS: To determine whether an educational intervention discussing thermal ablation of lateral margins of the mucosectomy site of post-endoscopic mucosal resection defect with snare tip soft coagulation (STSC) would decrease adenoma recurrence. METHODS: We performed a single-center quality improvement project from November 1, 2016, to November 30, 2017. Gastroenterologists underwent an educational intervention demonstrating the treatment of peripheral margins of mucosectomy site with STSC after standard mucosectomy technique. These cases (intervention group) were compared with consecutive procedures performed prior to commencement of the quality improvement study (pre-intervention group). Patients with large colorectal lesions (≥ 20 mm) were included. RESULTS: Of the 120 patients here included, overall demographics of the groups were similar and the most common histology was sessile serrated adenoma (study group 45% vs 32% control group). Adenoma recurrence on intervention group and pre-intervention group was 12% versus 30%; p = 0.01. On univariate analysis, biopsy prior to mucosectomy, intraprocedural bleeding, and application of STSC on mucosectomy defect were the strongest predictors of adenoma recurrence. Adenoma recurrence in the intervention group was significantly lower than in the pre-intervention group in both univariate (odds ratio, 0.3 [95% CI, 0.11-0.80]) and multivariate analyses (odds ratio, 0.2 [95% CI, 0.12-0.92]). CONCLUSIONS: The implementation of STSC of post-endoscopic mucosal resection peripheral defects is clinically feasible and significantly decreased adenoma recurrence.
BACKGROUND: Up to 20% of patients can have recurrence of adenomatous tissue at first surveillance study after colon endoscopic mucosal resection of large polyps. AIMS: To determine whether an educational intervention discussing thermal ablation of lateral margins of the mucosectomy site of post-endoscopic mucosal resection defect with snare tip soft coagulation (STSC) would decrease adenoma recurrence. METHODS: We performed a single-center quality improvement project from November 1, 2016, to November 30, 2017. Gastroenterologists underwent an educational intervention demonstrating the treatment of peripheral margins of mucosectomy site with STSC after standard mucosectomy technique. These cases (intervention group) were compared with consecutive procedures performed prior to commencement of the quality improvement study (pre-intervention group). Patients with large colorectal lesions (≥ 20 mm) were included. RESULTS: Of the 120 patients here included, overall demographics of the groups were similar and the most common histology was sessile serrated adenoma (study group 45% vs 32% control group). Adenoma recurrence on intervention group and pre-intervention group was 12% versus 30%; p = 0.01. On univariate analysis, biopsy prior to mucosectomy, intraprocedural bleeding, and application of STSC on mucosectomy defect were the strongest predictors of adenoma recurrence. Adenoma recurrence in the intervention group was significantly lower than in the pre-intervention group in both univariate (odds ratio, 0.3 [95% CI, 0.11-0.80]) and multivariate analyses (odds ratio, 0.2 [95% CI, 0.12-0.92]). CONCLUSIONS: The implementation of STSC of post-endoscopic mucosal resection peripheral defects is clinically feasible and significantly decreased adenoma recurrence.
Authors: Farzan F Bahin; Mahendra Naidoo; Stephen J Williams; Luke F Hourigan; Donald G Ormonde; Spiro C Raftopoulos; Bronte A Holt; Rebecca Sonson; Michael J Bourke Journal: Clin Gastroenterol Hepatol Date: 2014-08-20 Impact factor: 11.382
Authors: Abhishek Bhurwal; Michael J Bartel; Michael G Heckman; Nancy N Diehl; Massimo Raimondo; Michael B Wallace; Timothy A Woodward Journal: Gastrointest Endosc Date: 2016-04-22 Impact factor: 9.427
Authors: Alan Moss; Stephen J Williams; Luke F Hourigan; Gregor Brown; William Tam; Rajvinder Singh; Simon Zanati; Nicholas G Burgess; Rebecca Sonson; Karen Byth; Michael J Bourke Journal: Gut Date: 2014-07-01 Impact factor: 23.059
Authors: David J Tate; Lobke Desomer; Amir Klein; Gregor Brown; Luke F Hourigan; Eric Y T Lee; Alan Moss; Donald Ormonde; Spiro Raftopoulos; Rajvinder Singh; Stephen J Williams; Simon Zanati; Karen Byth; Michael J Bourke Journal: Gastrointest Endosc Date: 2016-11-28 Impact factor: 9.427
Authors: Pujan Kandel; Murtaza Hussain; Deepesh Yadav; Santosh K Dhungana; Bhaumik Brahmbhatt; Massimo Raimondo; Frank J Lukens; Ghassan Bachuwa; Michael B Wallace Journal: Endosc Int Open Date: 2022-10-17
Authors: Saurabh Chandan; Antonio Facciorusso; Daryl Ramai; Smit Deliwala; Babu P Mohan; Lena L Kassab; Peter V Draganov; Mohamed O Othman; Gursimran S Kochhar Journal: Endosc Int Open Date: 2022-01-14
Authors: Gijs Kemper; Ayla S Turan; Erik J Schoon; Ruud W M Schrauwen; Ludger S M Epping; Christian Gerges; Torsten Beyna; Horst Neuhaus; Ufuk Gündug; Peter D Siersema; Erwin J M van Geenen Journal: Surg Endosc Date: 2021-06-02 Impact factor: 4.584