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

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World Journal of Gastrointestinal Endoscopy 2023年第5期15卷 386-396页

作者： Ankur P Patel Mai A Khalaf margarita riojas-barrett Tara Keihanian Mohamed O Othman Department of Internal Medicine Baylor College of MedicineHoustonTX 77030United States Department of Tropical Medicine Tanta UniversityTanta 31527Egypt Department of Gastroenterology Baylor College of MedicineHoustonTX 77030United States

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

关键词： Appendiceal orifice polyps Endoscopic mucosal resection Endoscopic submucosal dissection Polyp resection Adenomatous polyps En bloc resection

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