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Endoscopic resection of large anastomotic polyps is safe and effective.
Cronin, Oliver; Gupta, Sunil; Gauci, Julia; Whitfield, Anthony; O'Sullivan, Timothy; Abuarisha, Muhammad; Wang, Hunter; Lee, Eric Yong Tat; Williams, Stephen J; Burgess, Nicholas Graeme; Bourke, Michael J.
Afiliação
  • Cronin O; Gastroenterology and Hepatology, Westmead Hospital, Westmead, Australia.
  • Gupta S; Medicine, The University of Sydney Westmead Clinical School, Sydney, Australia.
  • Gauci J; Gastroenterology and Hepatology, Westmead Hospital, Westmead, Australia.
  • Whitfield A; Medicine, The University of Sydney Westmead Clinical School, Sydney, Australia.
  • O'Sullivan T; Gastroenterology and Hepatology, Westmead Hospital, Westmead, Australia.
  • Abuarisha M; Medicine, The University of Sydney Westmead Clinical School, Sydney, Australia.
  • Wang H; Gastroenterology and Hepatology, Westmead Hospital, Westmead, Australia.
  • Lee EYT; Medicine, The University of Sydney Westmead Clinical School, Sydney, Australia.
  • Williams SJ; Gastroenterology and Hepatology, Westmead Hospital, Westmead, Australia.
  • Burgess NG; Medicine, The University of Sydney Westmead Clinical School, Sydney, Australia.
  • Bourke MJ; Gastroenterology and Hepatology, Westmead Hospital, Westmead, Australia.
Endoscopy ; 56(2): 125-130, 2024 Feb.
Article em En | MEDLINE | ID: mdl-37699523
BACKGROUND: Large (≥20mm) adenomatous anastomotic polyps (LAAPs) are uncommon. Data pertaining to their prevalence, characteristics, and the efficacy of endoscopic resection (ER) are absent. A safe and effective strategy for ER would reduce morbidity and healthcare costs. METHODS: Large nonpedunculated colorectal polyps of ≥20mm (LNPCPs) referred for ER were prospectively studied. Multiple data points were recorded including anastomotic location, polyp morphology, resection modality, complications, and technical success. RESULTS: Over 7 years until November 2022, 2629 lesions were referred. Of these, 10 (0.4%) were LAAPs (median size 35 mm [interquartile range (IQR) 30-40mm]). All LAAPs were removed by piecemeal endoscopic mucosal resection (EMR), most (n=9; 90%) in combination with cold-forceps avulsion with adjuvant snare-tip soft coagulation (CAST). On comparison of the LAAP group with the conventional LNPCP group, CAST was more commonly used (90% vs. 9%; P<0.001) and deep mural injury (DMI) type II was more frequent (40% vs. 11%, P=0.003); however, significant DMI (III-V) did not occur. At 6 month (IQR 5.25-6 months) surveillance, there was no recurrence in any of the 10 cases. There were no serious adverse events. CONCLUSIONS: LAAPs present unique challenges owing to their location overlying an anastomosis. Despite these challenges they can be safely and effectively managed endoscopically without recurrence at endoscopic follow-up.
Assuntos

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Neoplasias Colorretais / Pólipos do Colo / Pólipos Adenomatosos / Polipose Intestinal / Ressecção Endoscópica de Mucosa Idioma: En Ano de publicação: 2024 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Neoplasias Colorretais / Pólipos do Colo / Pólipos Adenomatosos / Polipose Intestinal / Ressecção Endoscópica de Mucosa Idioma: En Ano de publicação: 2024 Tipo de documento: Article