A national survey of endoscopic mucosal resection for superficial gastrointestinal neoplasia.
Endoscopy
; 42(10): 806-13, 2010 Oct.
Article
em En
| MEDLINE
| ID: mdl-20821362
ABSTRACT
BACKGROUND AND STUDY AIM:
Studies on endoscopic mucosal resection (EMR) are mostly based on data from centers with high expertise. We report the average EMR results in a national survey of consecutive patients in France.METHODS:
A 1-year survey was carried out to record immediate outcome data of all EMRs performed, regardless of lesion size or gastrointestinal location.RESULTS:
Overall, 1335 EMRs in 1210 patients were reported by 241 of the 736 gastroenterologists who performed such procedures (33â%). Resections were done for upper gastrointestinal lesions in 125 cases (41 esophageal, 43 gastric, and 41 duodenal lesions), in 45â% of cases using specific EMR techniques such as ligation, cap, or traction. The technique for resecting the 1210 lower gastrointestinal lesions mostly consisted of saline-assisted polypectomy or EMR, with specific techniques used in only 2.2â%. En bloc resection was less common with esophageal (46â%) or duodenal (54â%) neoplasms than in the lower gastrointestinal tract (73â%); size also had some influence (53â% > 1 cm vs. 92â% ≤ 1 cm). The overall complication rate was 5.2â%; the rate was lower for lesions 1 cm or smaller (0.6â% vs. 4.6â%). Fifty-four early and 17 delayed complications were recorded, in 12â% of upper gastrointestinal and 4.6â% of colonic lesions. Surgery became necessary in 1.6â% for upper and 2.9â% for lower gastrointestinal neoplasms. No association was seen between physician EMR caseload and either en bloc resection rate or complication rate.CONCLUSIONS:
EMR in general, especially saline-assisted polypectomy in the colon, appears to be reasonably safe even when performed by nonexperts. EMR for larger or for upper gastrointestinal lesions should probably be limited to high-volume centers.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Carcinoma
/
Endoscopia Gastrointestinal
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Mucosa Gástrica
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Neoplasias Gastrointestinais
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Mucosa Intestinal
Limite:
Aged
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Female
/
Humans
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Male
/
Middle aged
País/Região como assunto:
Europa
Idioma:
En
Revista:
Endoscopy
Ano de publicação:
2010
Tipo de documento:
Article
País de afiliação:
França