Efficacy of Cold Piecemeal Endoscopic Mucosal Resection of Medium to Large Adenomas Compared to Sessile Serrated Lesions

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Williams, Thomas J
Mickenbecker, Matthew
Smith, Nicholas
Bhasker, Vikas
Rubtsov, Denis
Jones, Andrew
Sabanathan, Jeevithan
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2024
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Abstract

Background and Aims There is growing evidence for the role of cold piecemeal endoscopic mucosal resection (C-EMR) in the treatment of colorectal lesions ≥10mm. However, it is unclear if it 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 (10-19mm) and large (≥20mm) serrated and adenomatous lesions.

Methods A retrospective analysis was performed of Paris IIa colonic lesions resected utilising 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 10mm to 50mm, with median size of 20mm. Ninety-five polyps were adenomatous, with 147 sessile serrated lesions (SSLs). At six month surveillance colonoscopy, the combined recurrence rate was 6.2%. Adenomas ≥20mm demonstrated a higher rate of recurrence (16.1%) compared to large SSLs (4.1%), medium adenomas (3.0%), and medium SSLs (1.4%). There were no adverse events reported following C-EMR.

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

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Gastrointestinal Endoscopy

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© 2024 by the American Society for Gastrointestinal Endoscopy. https://creativecommons.org/licenses/by/4.0/

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This publication has been entered in Griffith Research Online as an advance online version.

Copyright permissions for this publication were identified from the publisher's website at https://doi.org/10.1016/j.gie.2024.08.008

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Gastroenterology and hepatology

Clinical sciences

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Williams, TJ; Mickenbecker, M; Smith, N; Bhasker, V; Rubtsov, D; Jones, A; Sabanathan, J, Efficacy of Cold Piecemeal Endoscopic Mucosal Resection of Medium to Large Adenomas Compared to Sessile Serrated Lesions, Gastrointestinal Endoscopy, 2024

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