Department of Gastroenterology, Mayo Clinic, 4500 San Pablo Road South, Jacksonville, Florida 32224, USA.
Am J Gastroenterol. 2012 May;107(5):650-4. doi: 10.1038/ajg.2011.473.
We evaluated risk factors for residual neoplasia on first follow-up endoscopy after colonic endoscopic mucosal resections (EMRs).
This retrospective study in a high-volume EMR tertiary-referral center examined EMRs on 423 colonic lesions in 313 patients.
Residual neoplasia at first follow-up endoscopy was present following 12% of colonic EMRs. Single-variable analysis showed evidence of an increased risk of residual neoplasia for larger polyps, polyps without a lifting sign, and polyps removed piecemeal. In multivariable analysis, only use of the piecemeal method was independently associated with residual neoplasia.
Additional procedures are needed to complete resection in more than 1 in 10 colonic EMRs. Residual neoplasia occurs more often with piecemeal resection. Close surveillance after EMR and the use of newer methods to further reduce residual neoplasia are needed.
我们评估了结肠内镜黏膜切除术（EMR）后首次随访内镜下残留肿瘤的危险因素。
这项在高容量 EMR 三级转诊中心进行的回顾性研究检查了 313 名患者的 423 个结肠病变的 EMR。
12%的结肠 EMR 存在首次随访内镜下残留肿瘤。单变量分析显示，较大的息肉、无抬举征的息肉和分片切除的息肉存在残留肿瘤风险增加的证据。多变量分析显示，只有分片切除方法的使用与残留肿瘤独立相关。
超过 10%的结肠 EMR 需要额外的手术来完成切除。分片切除更容易发生残留肿瘤。EMR 后需要密切监测，并使用新的方法进一步降低残留肿瘤。
