Efficacy of precutting endoscopic mucosal resection with full or partial circumferential incision using a snare tip for difficult colorectal lesions.


Journal

Endoscopy
ISSN: 1438-8812
Titre abrégé: Endoscopy
Pays: Germany
ID NLM: 0215166

Informations de publication

Date de publication:
09 2019
Historique:
pubmed: 16 7 2019
medline: 4 6 2020
entrez: 16 7 2019
Statut: ppublish

Résumé

We analyzed the efficacy of precutting endoscopic mucosal resection (EMR), which is a method of making a full or partial circumferential mucosal incision around a tumor with a snare tip for en bloc resection. We reviewed cases from 2011 to 2018 in which precutting EMR (n = 167) and standard EMR (n = 557) were performed for lesions of 10 - 30 mm. Precutting EMR was indicated for benign lesions of 20 - 30 mm or lesions of < 20 mm for which standard EMR was difficult. Through propensity score matching of the two groups, the therapeutic outcomes for 35 lesions of ≥ 20 mm and 98 lesions of < 20 mm in each group were analyzed. In the two sizes of lesion, there were significant differences between the precutting and standard groups in the en bloc resection rate (≥ 20 mm 88.6 % vs. 48.5 %, Precutting EMR enabled high en bloc resection rates in cases involving difficult lesions.

Sections du résumé

BACKGROUND
We analyzed the efficacy of precutting endoscopic mucosal resection (EMR), which is a method of making a full or partial circumferential mucosal incision around a tumor with a snare tip for en bloc resection.
METHODS
We reviewed cases from 2011 to 2018 in which precutting EMR (n = 167) and standard EMR (n = 557) were performed for lesions of 10 - 30 mm. Precutting EMR was indicated for benign lesions of 20 - 30 mm or lesions of < 20 mm for which standard EMR was difficult. Through propensity score matching of the two groups, the therapeutic outcomes for 35 lesions of ≥ 20 mm and 98 lesions of < 20 mm in each group were analyzed.
RESULTS
In the two sizes of lesion, there were significant differences between the precutting and standard groups in the en bloc resection rate (≥ 20 mm 88.6 % vs. 48.5 %,
CONCLUSION
Precutting EMR enabled high en bloc resection rates in cases involving difficult lesions.

Identifiants

pubmed: 31307100
doi: 10.1055/a-0956-6879
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

871-876

Commentaires et corrections

Type : CommentIn
Type : CommentIn

Informations de copyright

© Georg Thieme Verlag KG Stuttgart · New York.

Déclaration de conflit d'intérêts

Drs. Yoshida and Naito have received research grants from FUJIFILM Medical Co., Ltd.

Auteurs

Naohisa Yoshida (N)

Department of Molecular Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan.

Ken Inoue (K)

Department of Molecular Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan.

Osamu Dohi (O)

Department of Molecular Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan.

Ritsu Yasuda (R)

Department of Molecular Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan.

Ryohei Hirose (R)

Department of Molecular Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan.

Yuji Naito (Y)

Department of Molecular Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan.

Takaaki Murakami (T)

Department of Gastroenterology, JCHO Kyoto Kuramaguchi Medical Center, Kyoto, Japan.

Kiyoshi Ogiso (K)

Department of Gastroenterology, Osaka General Hospital of West Japan Railway Company, Osaka, Japan.

Yutaka Inada (Y)

Department of Gastroenterology, Fukuchiyama City Hospital, Kyoto, Japan.

Yoshikazu Inagaki (Y)

Department of Gastroenterology, Nishijin Hospital, Kyoto, Japan.

Yukiko Morinaga (Y)

Department of Surgical Pathology, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan.

Mitsuo Kishimoto (M)

Department of Surgical Pathology, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan.

Yoshito Itoh (Y)

Department of Molecular Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan.

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