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논문 기본 정보
- 자료유형
- 학술저널
- 저자정보
- 발행연도
- 2017.1
- 수록면
- 502 - 510 (9page)
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초록· 키워드
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Background/Aims: Precutting before endoscopic piecemeal mucosal resection (EPMR) may increase colorectal polyp resection effectiveness. We aimed to identify risk factors for recurrence after conventional EPMR (CEPMR) and precut EPMR (PEPMR) and investigated endoscopic treatment outcomes for recurrent cases. Methods: The medical records of patients with colorectal polyps treated by EPMR were analyzed. Patients without follow-up surveillance colonoscopies were excluded. Results: Among 359 lesions, the local recurrence rate on the first surveillance colonoscopy was 5.8% (18/312) and 6.4% (3/47) after CEPMR and PEPMR, respectively. Among lesions without recurrence at the first surveillance colonoscopy, the rates of late recurrence on subsequent surveillance colonoscopy were 3.9% (6/152) and 0% after CEPMR and PEPMR, respectively. Larger tumor size was the only independent risk factor for recurrence (odds ratio, 7.93; 95% confidence interval, 1.95–32.30; P<0.001). Endoscopic treatment was performed for all 27 recurrences. A combination of ≥2 endoscopic treatment modalities was used in 19 of 27 recurrences (70.4%). Surveillance colonoscopies were performed in 20 of 27 recurrences after endoscopic treatment. One (5.0%) had a re-recurrence and was treated by surgical resection because recurrence occurred at the appendiceal orifice. Nineteen of 20 lesions (95.0%) could be cured endoscopically, although 3 of the 19 showed second or third recurrences and were treated by repeat endoscopic resection. Conclusions: The local recurrence rates after CEPMR and PEPMR were similar. Larger tumor size was an independent risk factor for local recurrence after EPMR. Endoscopic treatment of recurrences resulted in high cure rates, although combination methods were necessary in many cases.
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참고문헌 (24)
참고문헌 신청
Moss A / 2015 / Long-term adenoma recurrence following wide-field endoscopic mucosal resection (WF-EMR) for advanced colonic mucosal neoplasia is infrequent:results and risk factors in 1000 cases from the Australian Colonic EMR (ACE) study / Gut 64:57~65
Khashab M / 2009 / Incidence and predictors of “late” recurrences after endoscopic piecemeal resection of large sessile adenomas / Gastrointest Endosc 70:344~349
Oka S / 2015 / Local recurrence after endoscopic resection for large colorectal neoplasia: a multicenter prospective study in Japan / Am J Gastroenterol 110:697~707
Tanaka S / 2001 / Clinicopathologic features and endoscopic treatment of superficially spreading colorectal neoplasms larger than 20 mm / Gastrointest Endosc 54:62~66
Yang DH / 2015 / The feasibility of performing colorectal endoscopic submucosal dissection without previous experience in performing gastric endoscopic submucosal dissection / Dig Dis Sci 60:3431~3441
Khashab M / 2009 / Incidence and predictors of “late” recurrences after endoscopic piecemeal resection of large sessile adenomas / Gastrointest Endosc 70:344~349
Oka S / 2015 / Local recurrence after endoscopic resection for large colorectal neoplasia: a multicenter prospective study in Japan / Am J Gastroenterol 110:697~707
Tanaka S / 2001 / Clinicopathologic features and endoscopic treatment of superficially spreading colorectal neoplasms larger than 20 mm / Gastrointest Endosc 54:62~66
Yang DH / 2015 / The feasibility of performing colorectal endoscopic submucosal dissection without previous experience in performing gastric endoscopic submucosal dissection / Dig Dis Sci 60:3431~3441
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