Endoscopic Mucosal Resection (EMR) for polyps and complex-adenoma lessions of the colon. Recopilation of 15 years of experience (2004-2018)

Keywords: Colonic Polyps, Endoscopic Mucosal Resection

Abstract

Background: Detection and resection of colonic polypoid sessile and flat lesions, prevents the development of colon cancer. Endoscopic mucosal resection (EMR) has emerged in the 70´s and improved in the 80´s, as an alternative treatment of this lesions and is considered the procedure of choice nowadays, being able to avoid major surgical procedures. Objectives: Evaluation of the results and complications of the technique by endoscopists of a reference center. Review of indications and limitations of the technique. Material and methods: Descriptive, retrospective and observational analysis of patients treated with endoscopic mucosal resection technique at a referral center in Lima, Peru, between January 2004 and December 2018.
EMR Technique was used in polypoid lesions greater than 1 cm. The bloc resection and the piecemeal resection technique was used for those lesions up to 3 cm and more. We evaluated complications and results according to the technique as recurrence rate, performing tracking in all cases with endoscopic follow up. Results: 756 lesions and patients (338 women and 298 men) The average age was 61.9 years (37-91 years) and the average lesion size of 20.3 mm (10-50 mm). En bloc or one-piece resection was performed in 78.04 %(590) and piece meal in 21.96%(166) achieving endoscopic and pathological resection. The complication rate in our series was 6.74% and managed endoscopically and with conservative measures and no surgery. Mean follow-up was 18 months (3-24 months) and overall local recurrence rate was 2.49%. After-procedure,
additional surgical treatment was performed in 15 cases with pathologic piece report and intramucous adenocarcinoma (IM-ADCA). 13 of 15 local recurrences at 12 months follow up were treated endoscopically and 2 had surgical treatment. Conclusions: Endoscopic mucosal resection (EMR) or Mucosectomy is a technique performed by experts endoscopists and shows low rates of recurrence and complications with suitable material for pathologic examination. It reduces open and laparoscopic surgery.

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Published
2022-09-29
How to Cite
1.
Yriberry S, Velarde Criado H, Salazar Muente F, Barriga Briceño JA, Barreda Costa C, Piccini Larco R, Suárez Arellano D, Recavarren Asencios C, Emanuel P. Endoscopic Mucosal Resection (EMR) for polyps and complex-adenoma lessions of the colon. Recopilation of 15 years of experience (2004-2018) . Acta Med Peru [Internet]. 2022Sep.29 [cited 2022Dec.1];39(3). Available from: https://amp.cmp.org.pe/index.php/AMP/article/view/2404
Section
ORIGINAL ARTICLES