Endoscopic mucosal resection of flat and sessile colorectal adenomas: Our experience with long-term follow-ups

Saša Grgov; Predrag Dugalić; Ratko Tomašević; Tomislav Tasić

doi:10.2298/1864

Saša Grgov Department of Gastroenterology and Hepatology, General Hospital Leskovac, Leskovac, Serbia
Predrag Dugalić Department of Gastroenterology, Clinical Hospital Centre Zemun, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
Ratko Tomašević Department of Gastroenterology, Clinical Hospital Centre Zemun, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
Tomislav Tasić Department of Gastroenterology and Hepatology, General Hospital Leskovac, Leskovac, Serbia

DOI: https://doi.org/10.2298/1864

Keywords: adenoma, colorectal neoplasms, endoscopy, digestive system, treatment outcome,

Abstract

Bacground/Aim. Endoscopic mucosal resection (EMR) or mucosectomy is a removing method of flat or sessile lesions, laterally spreading tumors and carcinoma of the colon or the rectum limited to mucosa or the surface part of the submucosa. The aim of the study was to estimate the efficacy and safety of EMR in removing flat and sessile colorectal adenomas. Methods. This prospective study involved 140 patients during the period of 8 years. A total of 187 colorectal adenomas were removed using the EMR method “inject and cut with snare”. Results. The approximate size of mucosectomised adenomas was 13.6 mm (from 8 mm to 60 mm). There was a total of 48 (25.7%) flat adenomas and 139 (74.3%) sessile adenomas, (p < 0.01). Using “en bloc” and “piecemeal” resection, 173 (92.5%) and 14 (7.5%) of colorectal adenomas were removed, respectively. In all the cases, a complete removal of colorectal adenomas was achieved. Two (1.4%) patients had adenoma removal with intramucosal carcinoma each. In the average follow-up period of 21.2 ± 17.8 months, 2 (1.4%) patients had adenoma relapse after EMR. Considering complications, there was bleeding in 1 (0.7%) patient with a big rectum adenoma removed with EMR. Furthermore, one (0.7%) patient had a postcoagulation syndrome after cecal adenoma was removed by EMR. Conclusion. EMR is an efficient, safe and minimally invasive technique of removing flat and sessile adenomas in the colon and the rectum, with a very low percentage of adenoma recurrence over a long period of monitoring.

Author Biographies

Saša Grgov, Department of Gastroenterology and Hepatology, General Hospital Leskovac, Leskovac, Serbia

Research associate prim. dr sci med. Saša Grgov

Department of gastroenterology and hepatology

General hospital Leskovac

Rade Končara 9, 16000 Leskovac, Serbia

Tel. + 381 16 244972

Fax. + 381 16 3415411

Email: grgov@open.telekom.rs

Predrag Dugalić, Department of Gastroenterology, Clinical Hospital Centre Zemun, Faculty of Medicine, University of Belgrade, Belgrade, Serbia

Chiefe of Department of gastroenterology KBC Zemun, Clinical hospital of School of medicine University of Belgrade

Ratko Tomašević, Department of Gastroenterology, Clinical Hospital Centre Zemun, Faculty of Medicine, University of Belgrade, Belgrade, Serbia

KBC Zemun, Department of gastroeterology, Clinical hospital of School of medicine University of Belgrade

Tomislav Tasić, Department of Gastroenterology and Hepatology, General Hospital Leskovac, Leskovac, Serbia

General hospital Leskovac, Department of Gastroenterology and hepatology

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