Vnitr Lek 2016, 62(5):365-369

The efficacy of treatment of local residual neoplasia under standardized conditions

Ondřej Urban^1,2, Barbora Pipek¹, Ivana Mikoviny Kajzrlíková³, Přemysl Falt^1,2,*, Petr Fojtík¹, Petr Vítek^2,3

¹ Digestive Diseases Center, Vítkovice Hospital, Ostrava

² Faculty of Medicine, University of Ostrava, Ostrava

³ Beskydy Gastrocenter, Frýdek-Místek Hospital, Frýdek-Místek

Objectives:
Piecemeal endoscopic mucosal resection (EMR) is frequently used for the treatment of non-polypoid colorectal lesions larger than 20 mm. Nevertheless, local residual neoplasia occurs (LRN) in as much as 15 % of cases. The aim of our prospective interventional study was to evaluate the efficacy of treatment of LRN under standardized conditions.

Methods:
In two high volume non-university endoscopy centers, LRN has been treated according to the newly proposed classification based on endoscopic appearance by argon plasma coagulation (APC), endoscopic mucosal resection (EMR) or endoscopic submucosal dissection (ESD). Primary outcome, efficacy of LRN treatment, was defined as both endoscopic and histological absence of neoplastic tissue in the post-EMR site 6 months after LRN treatment session.

Results:
Twenty-five patients with 25 LRN lesions were enrolled. Among them, 12 (48 %), 8 (32 %) and 5 (20 %) were treated by APC, EMR and ESD, respectively, with efficacy in 10 (90.9 %), 7 (87.5 %) and 4 (100 %), respectively.

Conclusions:
Using standardized approach based on therapy directed by LRN morphology, LRN may be eradicated in 91.3 % during one session.

Keywords: colonoscopy; endoscopic mucosal resection; local residual neoplasia

Received: February 8, 2016; Accepted: March 26, 2016; Published: May 1, 2016  Show citation