(Endoscopy Center, Shanghai Tongren Hospital, Medical College, Shanghai Jiaotong University, Shanghai 200336, China)
Abstract:
Objective To assess the safety and efficacy of endoscopic mucosal resection (EMR) in treatment of elevated colorectal lesions, and the risk factors influencing the local recurrence. Methods Total 450 patients with 626 colorectal lesions, who underwent EMR from Jan 2009 to Dec 2012 in the endoscopic center of Tongren Hospital, were enrolled. The information of histological pathology and postoperative complication were documented. Among 450 patients, 180 patients had regular follow-up in our center, and the local recurrences were observed and recorded. Chi-square test and Logistic regression analysis were used for statistical analysis. Results The number of lesions Φ≤1.0cm, 1.0＜Φ≤2.0cm, 2.0＜Φ≤3.0cm and Φ＞3.0cm was 278,0, 52 and 16, respectively. Histologically, adenocarcinoma was reported in 7 patients. low-grade intraepithelial neoplasia in 314 patients, high-grade intraepithelial neoplasia in 43 patients, adenomatous polyp in 23, non-adenomatous polyp in 44, and stromal tumor or other histopathological diagnosis in 19 patients. All lesions were resected by EMR en bloc. Among 450 patients, 11 had postoperative complication, including bleeding or perforation. Among 180 patients who were followed-up for 6-36 months, local recurrence was discovered in 39 cases, including 32 cases with the recurrence within 12 months. Logistic regression showed that the number of lesions and the history of colorectal tumor surgery were risk factors of local recurrence (P＜0.05). Conclusion EMR is a safe and effective procedure to treat elevated colorectal lesions. For the patients with high risks of local recurrence, the endoscopic follow-up within 6 months is essential.
