Efficacy and Safety of a Novel Triple-anchoring Technique for Colonic Hybrid Endoscopic Mucosal Resection: A Case Series.


Journal

Journal of gastrointestinal and liver diseases : JGLD
ISSN: 1842-1121
Titre abrégé: J Gastrointestin Liver Dis
Pays: Romania
ID NLM: 101272825

Informations de publication

Date de publication:
19 03 2022
Historique:
received: 21 01 2022
accepted: 04 03 2022
entrez: 20 3 2022
pubmed: 21 3 2022
medline: 7 4 2022
Statut: epublish

Résumé

A hybrid technique may be a reasonable compromise to make endoscopic mucosal resection (EMR) more reliable for lesions ≥ 20 mm and a good way of approaching to endoscopic submucosal dissection (ESD). The aim of this study was to assess the efficacy and safety of a novel hybrid EMR technique, triple-anchoring EMR (T-EMR) for colorectal lesions 20-30 mm. Fifteen patients have been prospectively enrolled to T-EMR from December 2019 to April 2020 in two Endoscopy Units: Policlinico A. Gemelli, Rome, and University Hospital of Udine, Italy. Patients eligible for the study were ≥18 years old with superficial colorectal lesions 20-30 mm, morphologically liable to endoscopic treatment based on chromoendoscopy. The primary endpoint was assessment of the "en bloc" and the free resection margins (R0) rates. The secondary endpoints were resected specimen size, procedure time, complication rate, and recurrence rate at 6 months. Among the 15 patients enrolled, 12 were males (80%), mean age 68.73±11.04 years. The mean size of the lesions was 24.93±2.89 mm. Mean procedure time was 22.13±4.31 min. T-EMR was performed en bloc in 14/15 patients (93.3%) with R0 in 13/15 patients (86.7%). No major intra-/peri-procedural or delayed complications occurred. At histological analysis, 13/15 lesions (86.7%) were adenomas, while 2 were early colorectal cancer. At a 6-month follow-up colonoscopy, only one patient (6.7%) had a recurrence of adenoma. T-EMR seems to be an effective and safe option to treat colorectal lesions between 20 and 30 mm, with a short procedure time and low costs.

Sections du résumé

BACKGROUND AND AIMS
A hybrid technique may be a reasonable compromise to make endoscopic mucosal resection (EMR) more reliable for lesions ≥ 20 mm and a good way of approaching to endoscopic submucosal dissection (ESD). The aim of this study was to assess the efficacy and safety of a novel hybrid EMR technique, triple-anchoring EMR (T-EMR) for colorectal lesions 20-30 mm.
METHODS
Fifteen patients have been prospectively enrolled to T-EMR from December 2019 to April 2020 in two Endoscopy Units: Policlinico A. Gemelli, Rome, and University Hospital of Udine, Italy. Patients eligible for the study were ≥18 years old with superficial colorectal lesions 20-30 mm, morphologically liable to endoscopic treatment based on chromoendoscopy. The primary endpoint was assessment of the "en bloc" and the free resection margins (R0) rates. The secondary endpoints were resected specimen size, procedure time, complication rate, and recurrence rate at 6 months.
RESULTS
Among the 15 patients enrolled, 12 were males (80%), mean age 68.73±11.04 years. The mean size of the lesions was 24.93±2.89 mm. Mean procedure time was 22.13±4.31 min. T-EMR was performed en bloc in 14/15 patients (93.3%) with R0 in 13/15 patients (86.7%). No major intra-/peri-procedural or delayed complications occurred. At histological analysis, 13/15 lesions (86.7%) were adenomas, while 2 were early colorectal cancer. At a 6-month follow-up colonoscopy, only one patient (6.7%) had a recurrence of adenoma.
CONCLUSIONS
T-EMR seems to be an effective and safe option to treat colorectal lesions between 20 and 30 mm, with a short procedure time and low costs.

Identifiants

pubmed: 35306556
doi: 10.15403/jgld-4225
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

25-30

Auteurs

Jun Hamanaka (J)

Division of Gastroenterology ,Yokohama City University, Yokohama, Japan. . juncham@hotmail.com.

Salvatore F Vadalà di Prampero (SF)

Gastroenterology and GI Endoscopy Unit, Mater Olbia Hospital, Qatar Foundation Endowment and Gemelli Foundation, Olbia; Gastroenterology and GI Endoscopy Unit, University Hospital of Udine, Udine, Italy. salvatore.vadaladiprampero@materolbia.com.

Sonia Solito (S)

Gastroenterology and GI Endoscopy Unit, University Hospital of Udine, Udine, Italy. sonia.solito@asufc.sanita.fvg.it.

Milutin Bulajic (M)

Gastroenterology and GI Endoscopy Unit, Mater Olbia Hospital, Qatar Foundation Endowment and Gemelli Foundation, Olbia; Gastroenterology and GI Endoscopy Unit, University Hospital of Udine, Udine, Italy. bulajic.milutin@gmail.com.

Alessandro Picci (A)

Division of Internal Medicine, Department of Medicine, University Hospital of Udine, Udine, Italy. aless.picci@gmail.com.

Nikola Panic (N)

Dr Dragisa Misovic-Dedinje, Center for Digestive Endoscopy, Belgrade; School of Medicine, University of Belgrade, Belgrade, Serbia. nikola.panicmail@gmail.com.

Serena Battista (S)

Department of Pathology, University Hospital of Udine, Udine, Italy. serena.battista@asufc.sanita.fvg.it.

Federico Barbaro (F)

Digestive Endoscopy Unit, Università Cattolica del Sacro Cuore, Rome, Italy. federico.barbaro@policlinicogemelli.it.

Shin Maeda (S)

Division of Gastroenterology ,Yokohama City University, Yokohama, Japan. smaeda@yokohama-cu.ac.jp.

Guido Costamagna (G)

Digestive Endoscopy Unit, Università Cattolica del Sacro Cuore, Rome, Italy. guido.costamagna@unicatt.it.

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