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Endoscopic mucosal resection of colorectal polyps in typical UK hospitals

World Journal of Gastroenterology 2010年第42期16卷 5324-5328页

作者： Teegan R Lim Venkat Mahesh Salil Singh Benjamin HL Tan Mohamed Elsadig Nerukav Radhakrishnan Phil Conlong Chris Babbs regi george Department of Gastroenterology and Medicine Rochdale InfirmaryRochdaleOL12 0NBUnited Kingdom Department of Gastroenterology and Medicine Royal Oldham HospitalOldhamOL1 2JHUnited Kingdom Department of Gastroenterology and Medicine Salford Royal HospitalStott LaneSalfordM6 8HDUnited Kingdom Division of Gastrointestinal Surgery Nottingham Digestive Diseases Centre NIHR Biomedical Research UnitNottingham University HospitalsQueen's Medical CentreNottinghamNG7 2 UHUnited Kingdom

AIM:To evaluate the outcomes of endoscopic mucosal resection(EMR) for colorectal polyps,with particular regard to procedural complications and recurrence rate,in typical United Kingdom(UK) hospitals that perform an average of about 25 colonic EMRs per ***:A total of 239 colorectal polyps(≥ 10 mm) resected from 199 patients referred to Rochdale Infirmary,Salford Royal Hospital and Royal Oldham Hospital for EMR between January 2003 and January 2009 were ***:The mean size of polyps resected was 19.6 ± 12.4 mm(range 10-80 mm).The overall major complication rate was 2.1%.Complications were less frequent with non-adenomas compared with the other groups(Pearson's χ 2 test,P < 0.0001).Resections of largersized polyps were more likely to result in complications(unpaired t-test,P = 0.021).Recurrence was associated with histology,with carcinoma-in-situ more likely to recur compared with low-grade dysplasia [hazard ratio(HR) 186.7,95% confidence interval(95% CI):8.81-3953.02,P = 0.001].Distal lesions were also more likely to recur compared with right-sided and transverse colon lesions(HR 5.93,95% CI:1.35-26.18,P = 0.019).CONCLUSION:EMR for colorectal polyps can be performed safely and effectively in typical UK *** follow-up is required for histologically advanced lesions due to increased recurrence risk.

关键词： Endoscopic mucosal resection Polyps Endoscopic Resection

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Gastric endoscopic submucosal dissection as a treatment for early neoplasia and for accurate staging of early cancers in a United Kingdom Caucasian population

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World Journal of Gastrointestinal Endoscopy 2017年第12期9卷 561-570页

作者： Aisha Sooltangos Matthew Davenport Stephen McGrath Jonathan Vickers Siba Senapati Kurshid Akhtar regi george Yeng Ang Faculty of Biology Medicine and Health University of Manchester Department of Gastroenterology Salford Royal NHS Foundation Trust Department of Pathology Salford Royal NHS Foundation Trust Department of Upper Gastrointestinal Surgery Salford Royal NHS Foundation Trust Department of Gastroenterology Pennine Acute NHS Trust Gastrointestinal Science University of Manchester

AIM To investigate the efficacy of endoscopic submucosal dissection(ESD) at diagnosing and treating superficial neoplastic lesions of the stomach in a United Kingdom Caucasian *** Data of patients treated with or considered for ESD at a tertiary referral center in the United Kingdom were retrieved for a period of 2 years(May 2015 to June 2017) from the electronic patient records of the hospital. Only Caucasian patients were included. Primary outcomes were curative resection(CR) and were defined as ESD resections with clear horizontal and vertical margin and an absence of lympho-vascular invasion, poor differentiation and submucosal involvement on histological evaluation of the resected specimen. Secondary end-points were reversal of dysplasia at 12 mo endoscopic follow-up and/or at the latest follow up. Change in histological diagnosis pre and post ESD was also *** Twenty-four patients were initially identified with intention to treat. 19 patients were eligible after mapping gastroscopy and ESD was attempted on a total of 25 ESD lesions, 4 of which failed and had to be aborted mid-procedure. Out of 21 ESD performed, en-bloc resection was achieved in 71.4% of cases. Resection was considered complete on endoscopy in 90.5% of cases compared to only 38.1% on histology. A total of 6 resections were considered curative(28%), 5 noncurative(24%) and 10 indefinite for CR or non-CR(24%). ESD changed the histological diagnosis in 66.6% of cases post ESD. Endoscopic follow-up in the "indefinite" group and CR group showed that 50% and 80% of patients were clear of dysplasia at the latest follow-up respectively; 2 cases of recurrence were observed in the "indefinite"group. Survival rate for the entire cohort was 91.7%.CONCLUSION This study provides early evidence for the efficacy of ESD as a therapeutic and diagnostic intervention in Caucasian populations and supports its application in the United Kingdom.

关键词： Endoscopic resection Endoscopic submucosal dissection Endoscopic mucosal resection Dysplasia Early gastric cancer United Kingdom

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