Endoscopy cornerEfficacy of Endoscopic Mucosal Resection With Circumferential Incision for Patients With Large Colorectal Tumors
Section snippets
Methods
We retrospectively analyzed the data of all patients undergoing endoscopic treatment for neoplastic lesions >20 mm in size at the National Cancer Center Hospital from March 2008–July 2009. Written informed consent to participate was obtained from all patients who underwent colonoscopy examination or any form of treatment. CEMR was performed at our institution according to the following inclusion criteria, which partially overlap with those for ESD: lesions with a diameter of 20–40 mm
Results
The clinicopathologic features and outcomes are summarized in Tables 1 and 2, respectively. Of the 24 patients, 10 (42%) were men, and the median (IQR) age was 69 years (59–75 years). Three lesions were located in the cecum, 6 in the ascending colon, 3 in the transverse colon, 3 in the descending colon, 4 in the sigmoid colon, and 5 in the rectum. Morphologically, 11 were polypoid (0-Is, Is+IIa), and 12 were elevated (0-IIa, IIa+IIc) and depressed (0-IIc). Of all the patients, only 1 (4%) was
Discussion
Here we assessed the clinical outcome of CEMR in patients with relatively large neoplasms. The advantages of using this procedure over conventional EMR for large sessile lesions has already been reported by Moss et al.24 In that study, the rate of en bloc resection (70%) reflected the convenience of its use for imaginary lesions of porcine colon sized 40 × 40 mm. In our study, the en bloc resection rate was unexpectedly low (68%), yet the objective lesions were relatively smaller than those of
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Conflicts of interest The authors disclose no conflicts.