| Title: |
Endoscopic mucosal resection of large rectal adenomas in the era of centralization: Results of a multicenter collaboration |
| Authors: |
Barendse, RM; Musters, GD; Fockens, P; Bemelman, WA; de Graaf, EJ; van den Broek, FJ; van der Linde, K; Schwartz, MP; Houben, MH; van Milligen de Wit, AW; Witteman, BJ; Winograd, R; Dekker, E |
| Source: |
United European Gastroenterology Journal ; volume 2, issue 6, page 497-504 ; ISSN 2050-6406 2050-6414 |
| Publisher Information: |
Wiley |
| Publication Year: |
2014 |
| Collection: |
Wiley Online Library (Open Access Articles via Crossref) |
| Description: |
Background and objective Endoscopic mucosal resection (EMR) of large rectal adenomas is largely being centralized. We assessed the safety and effectiveness of EMR in the rectum in a collaboration of 15 Dutch hospitals. Methods Prospective, observational study of patients with rectal adenomas >3 cm, resected by piecemeal EMR. Endoscopic treatment of adenoma remnants at 3 months was considered part of the intervention strategy. Outcomes included recurrence after 6, 12 and 24 months and morbidity. Results Sixty‐four patients (50% male, age 69 ± 11, 96% ASA 1/2) presented with 65 adenomas (diameter 46 ± 17 mm, distance ab ano 4.5 cm (IQR 1–8), 6% recurrent lesion). Sixty‐two procedures (97%) were technically successful. Histopathology revealed invasive carcinoma in three patients (5%), who were excluded from effectiveness analyses. At 3 months’ follow‐up, 10 patients showed adenoma remnants. Recurrence was diagnosed in 16 patients during follow‐up (recurrence rate 25%). Fifteen of 64 patients (23%) experienced 17 postprocedural complications. Conclusion In a multicenter collaboration, EMR was feasible in 97% of patients. Recurrence and postprocedural morbidity rates were 25% and 23%. Our results demonstrate the outcomes of EMR in the absence of tertiary referral centers. |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| DOI: |
10.1177/2050640614554218 |
| Availability: |
https://doi.org/10.1177/2050640614554218; https://onlinelibrary.wiley.com/doi/pdf/10.1177/2050640614554218; https://onlinelibrary.wiley.com/doi/full-xml/10.1177/2050640614554218 |
| Rights: |
http://onlinelibrary.wiley.com/termsAndConditions#vor ; http://journals.sagepub.com/page/policies/text-and-data-mining-license |
| Accession Number: |
edsbas.B08B1196 |
| Database: |
BASE |