Endoscopy 2019; 51(04): S209-S210
DOI: 10.1055/s-0039-1681794
ESGE Days 2019 ePosters
Friday, April 5, 2019 09:00 – 17:00: Colon and rectum ePosters
Georg Thieme Verlag KG Stuttgart · New York

LONG TERM FOLLOW UP AFTER ENDOSCOPIC MUCOSAL RESECTION FOR LARGE AND CHALLENGING SUPERFICIAL RECTAL TUMOURS

A Alam
1   Gastro-Enterology, European Hospital Georges Pompidou, Paris, France
,
G Rahmi
1   Gastro-Enterology, European Hospital Georges Pompidou, Paris, France
,
G Perrod
1   Gastro-Enterology, European Hospital Georges Pompidou, Paris, France
,
S Khater
1   Gastro-Enterology, European Hospital Georges Pompidou, Paris, France
,
H Benosman
1   Gastro-Enterology, European Hospital Georges Pompidou, Paris, France
,
C Cellier
1   Gastro-Enterology, European Hospital Georges Pompidou, Paris, France
› Author Affiliations
Further Information

Publication History

Publication Date:
18 March 2019 (online)

Also available at
 

Aims:

Endoscopic mucosal resection (EMR) is a commonly used technique to remove colorectal polyps. In this study, we aimed to evaluate the success, complications and recurrence rate of EMR for large superficial rectal tumours.

Methods:

From January 2010 to January 2018, all patients treated by EMR for rectal superficial tumours larger than 20 mm, at our centre, were retrospectively included. Clinical, endoscopic and histological data were collected.

We defined “challenging” polyps as polyps presenting at least one of these features: size ≥4 cm, macronodules ≥10 mm, contact with pectinate line or rectosigmoid junction and invasive carcinoma”. Patients who had a surveillance colonoscopy within the year following EMR were assessed for recurrence rate.

Results:

A total of 81 patients were included (mean age 70.67, 55.6% men). The median polyp size was 28 (20; 60)mm. Histological analysis revealed low-grade dysplasia in 45.67%, high-grade dysplasia in 18.51%, intramucosal carcinoma in 4.93% and invasive carcinoma in 3.7%. The 4 cases of invasive carcinoma were referred to surgery.

53 patients (65.43%) only received a surveillance colonoscopy within the year with median follow-up of 4.34 (3; 11) months. The local recurrence rate was 9.43%.

After logistic regression analysis, no significant correlation was identified for size, location, Paris classification or piecemeal resection. Among “challenging” polyps (60.49% (49/81)), only 42% (34/81) were followed. Recurrence rate of these polyps were 14.70% versus 9.52% for non challenging polyps; p > 0.05.

Intraprocedural bleeding occurred in 14.8% of the cases, delayed bleeding in 4.9% and perforation in 3.7%. All complications were treated medically.

Conclusions:

Our study shows that EMR is an effective and safe technique for resection of large rectal polyps, with an overall recurrence rate of about 9.43%. EMR of challenging polyps may be associated with higher recurrence rate, but this data should be confirmed in large scale prospective study.