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Efficacy of cold piecemeal EMR of medium to large adenomas compared with sessile serrated lesions. | LitMetric

Efficacy of cold piecemeal EMR of medium to large adenomas compared with sessile serrated lesions.

Gastrointest Endosc

Department of Gastroenterology, Logan Hospital, Brisbane, Queensland, Australia; School of Medicine, Griffith University, Brisbane, Queensland, Australia. Electronic address:

Published: January 2025

AI Article Synopsis

  • This study examines the effectiveness and safety of cold piecemeal endoscopic mucosal resection (C-EMR) for removing colorectal lesions of varying sizes (10-50 mm) and types (serrated and adenomatous).
  • C-EMR was performed on 242 lesions in 151 patients, finding a 6.2% recurrence rate overall, with higher rates for larger adenomas (16.1%) compared to large sessile serrated lesions (4.1%) and smaller adenomas (3.0% for medium, 1.4% for medium SSLs).
  • The study concludes that while C-EMR is safe for all lesion types and

Article Abstract

Background And Aims: There is growing evidence for the role of cold piecemeal EMR (C-EMR) in the treatment of colorectal lesions ≥10 mm. However, it is unclear if C-EMR is equally efficacious for all histologic subtypes and sizes. This retrospective study compares the efficacy and safety of C-EMR in the resection of medium (10-19 mm) and large (≥20 mm) serrated and adenomatous lesions.

Methods: A retrospective analysis was performed of Paris IIa colonic lesions resected by using a C-EMR technique over a 3.5-year period at our center.

Results: C-EMR was performed for 242 lesions in 151 patients. Lesion size ranged between 10 and 50 mm, with a median size of 20 mm. Ninety-five polyps were adenomatous, with 147 sessile serrated lesions (SSLs). At 6-month surveillance colonoscopy, the combined recurrence rate was 6.2%. Adenomas ≥20 mm showed a higher rate of recurrence (16.1%) compared with large SSLs (4.1%), medium adenomas (3.0%), and medium SSLs (1.4%). There were no adverse events reported after C-EMR.

Conclusions: C-EMR seems to be less effective for the resection of large adenomas compared with medium adenomas or large SSLs. C-EMR is equally safe for all lesion sizes and histology.

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Source
http://dx.doi.org/10.1016/j.gie.2024.08.008DOI Listing

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