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Expanding endoscopic boundaries:Endoscopic resection of large appendiceal orifice polyps with endoscopic mucosal resection and endoscopic submucosal dissection

作     者:Ankur P Patel Mai A Khalaf Margarita Riojas-Barrett Tara Keihanian Mohamed O Othman 

作者机构:Department of Internal MedicineBaylor College of MedicineHoustonTX 77030United States Department of Tropical MedicineTanta UniversityTanta 31527Egypt Department of GastroenterologyBaylor College of MedicineHoustonTX 77030United States 

出 版 物:《World Journal of Gastrointestinal Endoscopy》 (世界胃肠内镜杂志(英文版)(电子版))

年 卷 期:2023年第15卷第5期

页      面:386-396页

学科分类:1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

主  题:Appendiceal orifice polyps Endoscopic mucosal resection Endoscopic submucosal dissection Polyp resection Adenomatous polyps En bloc resection 

摘      要:BACKGROUND Large appendiceal orifice polyps are traditionally treated ***,endoscopic mucosal resection(EMR)and endoscopic submucosal dissection(ESD)have been utilized as alternative resection *** To evaluate the efficacy and safety of endoscopic resection techniques for the management of large appendiceal orifice *** This was a retrospective observational study conducted to assess the feasibility and safety of EMR and ESD for large appendiceal orifice *** project was approved by the Baylor College of Medicine Institutional Review *** who underwent endoscopic resection of appendiceal orifice polyps≥1 cm from 2015 to 2022 at a tertiary referral endoscopy center in the United States were *** main outcomes of this study included en bloc resection,R0 resection,post resection adverse events,and polyp *** A total of 19 patients were *** patients were female(53%)and Caucasian(95%).The mean age was 63.3±10.8 years,and the average body mass index was 28.8±*** mean polyp size was 25.5±14.2 mm.74%of polyps were localized to the appendix(at or inside the appendiceal orifice)and the remaining extended into the cecum.68%of polyps occupied≥50%of the appendiceal orifice *** mean procedure duration was 61.6±37.9 *** were resected via endoscopic mucosal resection,endoscopic submucosal dissection,and hybrid procedures in 5,6,and 8 patients,*** pathology was remarkable for tubular adenoma(n=10)[one with high grade dysplasia],sessile serrated adenoma(n=7),and tubulovillous adenoma(n=2)[two with high grade dysplasia].En bloc resection was achieved in 84%with an 88%R0 resection *** the large polyp sizes and challenging procedures,89%(n=17)of patients were discharged on the same day as their *** patients were admitted for post-procedure observation for conservative pain *** patients underwent repeat colonoscopy without evide

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