The role of endoscopic mucosal resection in gastrointestinal precancerous lesions

Abstract

Objectives: Endoscopic mucosal resection (EMR) has

been widely used in early gastrointestinal malignancies and

precancerous lesions. We aim to analyze the outcomes of EMR for

gastrointestinal precancerous lesions.

Materials and Methods: A total of 1,518 cases were

retrospectively analyzed. Of these, 59 patients had undergone

EMR for gastrointestinal lesions. The lesions were divided into

two subgroups according to size; smaller than 20 mm and equal or

larger than 20 mm. The mucosal aspect (Kudo pit pattern), Paris

classification of the resected lesions and recurrences that were

determined during close follow-up were recorded.

Results: A total of 94 polyps were resected in 59 patients.

En-block resection was performed in 42 (71.2%) patients and

piecemeal resection in 17 (28.8%). There was no significant

difference between two modalities; regarding age, gender,

histopathology, complications, recurrence or macroscopic type

(P>0.05). However, the occurrence of Kudo type 4 lesions and

adenomatous polyps (P=0.001) was significant in the >20 mm

group (P=0.03).

Conclusion: Endoscopic mucosal resection is a safe and

feasible procedure for precancerous lesions, with low complication

and acceptable recurrence rates. Additionally, the Kudo pit pattern

should be taken into consideration on a routine basis when

determining the risk of cancer.

Keywords

• Endoscopic mucosal resection,Gastrointestinal precancerous lesion,Pit pattern,Recurrence

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