当前位置： SCI文献检索 > SCANDINAVIAN JOURNAL OF GASTROENTEROLOGY期刊下所有文献 > Long-term follow-up after EMR of large colorectal lesions: metachronous lesions, predictors and surveillance timing.

Long-term follow-up after EMR of large colorectal lesions: metachronous lesions, predictors and surveillance timing.

Abstract：

:Background: Endoscopic mucosal resection (EMR) is the first-line approach to large colorectal sessile lesions. These patients have been associated with high rates of metachronous lesions (ML), but long-term follow-up (LtFU) data are lacking. We aimed at evaluating the efficacy of an LtFU protocol and analyse the development and risk factors for ML.Methods: A prospectively collected database was analysed. Seventy-six patients submitted to EMR of large colorectal sessile lesions between 2007 and 2013 complied with a specific endoscopic surveillance, consisting of two protocols - initial follow-up (iFU) and LtFU. iFU intended to inspect the mucosectomy scars twice (at 3-6 and 12 months) and remove synchronous lesions (SL). Protocol examinations of LtFU were carried out at the first- and fourth-year post-iFU, aiming to remove ML. Statistical analysis included variables related to patient, index lesion, SL and ML characteristics.Results: Rates of ML were 39.5% and 20.4% at the first- and fourth-year of LtFU, and respectively 11.8% and 3.7% of them were advanced ML. All ML were endoscopically resectable. At univariate analysis, male gender (OR: 2.91; p=.029), the presence of SL (OR 3.86, p=.010) and advanced SL (OR 4.25, p=.006) were risk factors for ML. At multivariate analysis, male gender (p=.031) and advanced SL (p=.006) were significant predictors of ML development.Conclusions: We confirmed the increased risk of ML in patients with large colorectal lesions. A significant number of advanced ML was removed at the first LtFU colonoscopy, probably it should be carried out earlier than currently recommended.

journal_name

Scand J Gastroenterol

journal_title

Scandinavian journal of gastroenterology

authors

Costa D,Brandão M,Costa R,Gonçalves R,Braga A,Rolanda C

doi

10.1080/00365521.2019.1694066

subject

Has Abstract

pub_date

2019-12-01 00:00:00

pages

1487-1493

issue

12

eissn

0036-5521

issn

1502-7708

journal_volume

54

pub_type

杂志文章

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