Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Jan 7:13:a24798672.
doi: 10.1055/a-2479-8672. eCollection 2025.

Endoscopic mucosal resection defect inspection for predicting recurrences: International image-based survey

Gijs Kemper  1 , Ramon-Michel Schreuder  2 , R W M Schrauwen  3 , Jochim S Terhaar Sive Droste  4 , Peter Siersema  5 , Erwin-Jan M van Geenen  1
Affiliations

Endoscopic mucosal resection defect inspection for predicting recurrences: International image-based survey

Gijs Kemper et al. Endosc Int Open. .

Abstract

Background and study aims Endoscopic mucosal resection (EMR) is a safe and minimally invasive procedure to remove colorectal non-pedunculated polyps. Recurrence rates are relatively high and differ among endoscopists. We aimed to evaluate whether endoscopists are able to predict recurrence based on thorough inspection of images of mucosal defects after an assumed complete EMR. Methods We developed an online survey in which endoscopists were invited to indicate whether they expected recurrence to develop when inspecting 30 post-EMR defect images. All EMRs were considered to be complete resections by the performing endoscopist. Participating endoscopists were scored based on the number of correct answers regarding presence or absence of recurrence found at first surveillance colonoscopy. Results A total of 140 endoscopists responded to the survey (response rate 25%). A total of 124 respondents with a mean age of 46.5 years evaluated the 30 images. The overall score in the cohort was 70%, indicating that respondents were able to correctly predict recurrence in three-quarters of cases with an overall level of certainty of 53.4%. When comparing results of experienced and less experienced endoscopists based on the number of endoscopic submucosal dissections and/or EMRs performed yearly, no difference (71% versus 69%, P = 0.23) was found. Conclusions This study shows that recurrences after presumed complete EMR can reasonably well be predicted by both experienced and less experienced endoscopists when evaluating images with mucosal defects. Thorough inspection of the post-EMR defect may reduce recurrence rates by recognizing and subsequent treatment of suspect areas.

Keywords: Endoscopic resection (polypectomy, ESD, EMRc, ...); Endoscopy Lower GI Tract; Performance and complications; Polyps / adenomas / ...; Quality and logistical aspects.

PubMed Disclaimer

Conflict of interest statement

Conflict of Interest The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Flowchart of selection process for resection site images.
Fig. 2
Fig. 2
Examples of selected images. Imaging of resection site showing a recurrence and b no recurrence during follow-up.
See this image and copyright information in PMC

References

    1. Ferlitsch M, Moss A, Hassan C et al.Colorectal polypectomy and endoscopic mucosal resection (EMR): European Society of Gastrointestinal Endoscopy (ESGE) Clinical Guideline. Endoscopy. 2017;49:270–297. doi: 10.1055/s-0043-102569. - DOI - PubMed
    1. Belderbos TD, Leenders M, Moons LMG et al.Local recurrence after endoscopic mucosal resection of nonpedunculated colorectal lesions: systematic review and meta-analysis. Endoscopy. 2014;46:388–402. doi: 10.1055/s-0034-1364970. - DOI - PubMed
    1. Kemper G, Turan AS, Schoon EJ et al.Endoscopic techniques to reduce recurrence rates after colorectal EMR: systematic review and meta-analysis. Surg Endosc. 2021;35:5422–5429. doi: 10.1007/s00464-021-08574-z. - DOI - PMC - PubMed
    1. Pohl H, Srivastava A, Bensen SP et al.Incomplete polyp resection during colonoscopy-results of the complete adenoma resection (CARE) study. Gastroenterology. 2013;144:74–80 e1. - PubMed
    1. Klein A, Tate DJ, Jayasekeran V et al.Thermal ablation of mucosal defect margins reduces adenoma recurrence after colonic endoscopic mucosal resection. Gastroenterology. 2019;156:604–613 e3. doi: 10.1053/j.gastro.2018.10.003. - DOI - PubMed

LinkOut - more resources