Efficacy of precutting endoscopic mucosal resection with full or partial circumferential incision using a snare tip for difficult colorectal lesions.

Abstract:

BACKGROUND:We analyzed the efficacy of precutting endoscopic mucosal resection (EMR), which is a method of making a full or partial circumferential mucosal incision around a tumor with a snare tip for en bloc resection. METHODS:We reviewed cases from 2011 to 2018 in which precutting EMR (n = 167) and standard EMR (n = 557) were performed for lesions of 10 - 30 mm. Precutting EMR was indicated for benign lesions of 20 - 30 mm or lesions of < 20 mm for which standard EMR was difficult. Through propensity score matching of the two groups, the therapeutic outcomes for 35 lesions of ≥ 20 mm and 98 lesions of < 20 mm in each group were analyzed. RESULTS:In the two sizes of lesion, there were significant differences between the precutting and standard groups in the en bloc resection rate (≥ 20 mm 88.6 % vs. 48.5 %, P < 0.001; < 20 mm 98.0 % vs. 85.7 %, P = 0.004) and the histological complete resection rate (≥ 20 mm 71.4 % vs. 42.9 %, P = 0.02; < 20 mm 87.8 % vs. 67.3 %, P < 0.001). CONCLUSION:Precutting EMR enabled high en bloc resection rates in cases involving difficult lesions.

journal_name

Endoscopy

journal_title

Endoscopy

authors

Yoshida N,Inoue K,Dohi O,Yasuda R,Hirose R,Naito Y,Murakami T,Ogiso K,Inada Y,Inagaki Y,Morinaga Y,Kishimoto M,Itoh Y

doi

10.1055/a-0956-6879

subject

Has Abstract

pub_date

2019-09-01 00:00:00

pages

871-876

issue

9

eissn

0013-726X

issn

1438-8812

journal_volume

51

pub_type

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