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. 2012 May;107(5):650-4.
doi: 10.1038/ajg.2011.473.

Predictors of complete endoscopic mucosal resection of flat and depressed gastrointestinal neoplasia of the colon

Timothy A Woodward  1 , Michael G Heckman, Patrick Cleveland, Silvio De Melo, Massimo Raimondo, Michael Wallace
Affiliations

Predictors of complete endoscopic mucosal resection of flat and depressed gastrointestinal neoplasia of the colon

Timothy A Woodward et al. Am J Gastroenterol. 2012 May.

Abstract

Objectives: We evaluated risk factors for residual neoplasia on first follow-up endoscopy after colonic endoscopic mucosal resections (EMRs).

Methods: This retrospective study in a high-volume EMR tertiary-referral center examined EMRs on 423 colonic lesions in 313 patients.

Results: Residual neoplasia at first follow-up endoscopy was present following 12% of colonic EMRs. Single-variable analysis showed evidence of an increased risk of residual neoplasia for larger polyps, polyps without a lifting sign, and polyps removed piecemeal. In multivariable analysis, only use of the piecemeal method was independently associated with residual neoplasia.

Conclusions: Additional procedures are needed to complete resection in more than 1 in 10 colonic EMRs. Residual neoplasia occurs more often with piecemeal resection. Close surveillance after EMR and the use of newer methods to further reduce residual neoplasia are needed.

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