Colon mucosal neoplasia referred for endoscopic mucosal resection:Recurrence of adenomas and prediction of submucosal invasion

作     者：Mamoon Ur Rashid Neelam Khetpal Hammad Zafar Saeed Ali Evgeny Idrisov Yuan Du Assaf Stein Deepanshu Jain Muhammad Khalid Hasan 

作者机构：Department of Internal MedicineAdvent Health Graduate Medical EducationOrlandoFL 32804United States Department of Internal MedicineUniverity of Iowa hospitalIowa CityIA 52242United States Department of GastroenterologyUniversity of Oklahoma Health SciencesOklahomaOK 73104United States Center for Interventional EndoscopyAdventHealthOrlandoFL 32803United 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：2020年第12卷第7期

页      面：198-211页

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

主　　题：Endoscopy Polyp Endoscopic mucosal resection Recurrence Submucosal invasion 

摘      要：BACKGROUND Endoscopic mucosal resection(EMR)is an effective and minimally invasive alternative to surgery for large polyps and laterally spreading *** morphology and surface characteristics may help predict submucosal invasion of the lesion(SMIL)during endoscopic *** is one of the largest singlecenter studies reporting endoscopic mucosal resection for larger(≥20 mm)colorectal lesions in the United *** To determine the recurrence rate of adenomas and endoscopic features that may predict submucosal invasion of colonic mucosal *** This is a retrospective cohort study of all the patients referred for endoscopic mucosal resection for lesions≥20 mm,spanning a period from January 2013 to February *** main outcome measure was identifying features that may predict submucosal invasion of mucosal lesions and predict recurrence of adenomas on follow-up surveillance colonoscopy performed at 4-6 *** A total of 480 patients with 500 lesions were included in the *** median age was 68(Inter quantile range:14)with 52%*** most common lesion location was ascending colon(161;32%).Paris classification 0-IIa(Flat elevation of mucosa-316;63.2%);Kudo Pit Pattern IIIs(192;38%)and Granular surface morphology(260;52%)were most *** invasion was present in 23(4.6%)out of 500 *** independent risk factors for SMIL were Kudo Pit Pattern IIIL+IV and V(Odds ratio:4.5;P value40 mm).Almost all recurrences(98.8%)were treated endoscopically.