Endoscopic Mucosal Resection of Colorectal Polyps: Results, Adverse Events and Two-Year Outcome

Aims Endoscopic mucosal resection (EMR) is the first-line treatment for large sessile and flat colorectal polyps in Western centres. However, adenoma recurrence after EMR continues to be a challenge. The aim of this study is to assess the efficacy, safety and recurrence rate of EMR in a tertiary centre and to identify risk factors associated with local recurrence during first surveillance endoscopy (SE1).

Methods We performed a retrospective study of 165 sessile and flat colorectal lesions measuring ≥15 mm, treated by EMR from October 2017 to October 2019. Colonoscopy and pathology reports were reviewed to identify recurrence. We used multivariate logistic regression to identify independent risk factors for recurrence at SE1.

Results EMR was performed for 165 colorectal polyps in 142 patients and successful resection was achieved in 158 cases (95.2 %). SE1 data was available for 117 of 135 eligible cases (86.7 %) after a median time of 6.2 months (IQR 5-9.9), and showed recurrent adenoma in 19 cases (16.2 %). Recurrence was mainly treated endoscopically (78.9 %). Three patients (15.8 %) underwent surgery and one elected a conservative approach. Independent risk factors for recurrence at SE1 were lesion size ≥ 40 mm (odds ratio [OR] 4.03; p = 0.018) and presence of high-grade dysplasia (OR 3.89; p = 0.034). Early adverse event occurred in 4 patients (2.4 %) and consisted of 3 bleeding complications and 1 perforation. Twelve patients (7.2 %) presented with delayed bleeding of which 3 required transfusion, with radiological intervention in one case. All other complications were managed either conservatively (n = 8) or endoscopically (n = 5).

Conclusions EMR is a safe and effective treatment for large sessile and flat colorectal lesions with low recurrence rates. Lesion size ≥ 40 mm and presence of HGD were identified as risk factors for early recurrence, highlighting the importance of compliance to follow-up in these cases.

Citation: Chaoui I, Demedts I, Roelandt P et al. OP106 ENDOSCOPIC MUCOSAL RESECTION OF COLORECTAL POLYPS: RESULTS, ADVERSE EVENTS AND TWO-YEAR OUTCOME. Endoscopy 2021; 53: S45.

Publication History

Article published online:
19 March 2021