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Risk factors for incomplete resection and complications in endoscopic mucosal resection for lateral spreading tumors
Author(s) -
Kim Hyung Hun,
Kim Joo Hoon,
Park Seun Ja,
Park Moo In,
Moon Won
Publication year - 2012
Publication title -
digestive endoscopy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.5
H-Index - 56
eISSN - 1443-1661
pISSN - 0915-5635
DOI - 10.1111/j.1443-1661.2011.01232.x
Subject(s) - medicine , resection , lesion , surgery , endoscopic mucosal resection , retrospective cohort study
Aim: Lateral spreading tumors (LST) are relatively large flat lesions with diameters exceeding 10 mm in length. Endoscopic mucosal resection (EMR) is a commonly used technique for removing LST. We aimed to evaluate the risk factors for incomplete resection and complications of EMR for LST. Method: Between January 2004 and December 2010, 497 patients who underwent EMR for LST were retrospectively reviewed. Risk factors for endoscopic and histopathological complete resection, complications, and clinical outcomes were investigated. Results: Risks for incomplete resection by piecemeal resection and en bloc resection of a lesion ≥30 mm were higher than for en bloc resection of a lesion <30 mm (OR = 2.688, CI 1.036–6.993; OR = 4.982, CI 1.894–13.101). Risks of post‐EMR bleeding for piecemeal resection and en bloc resection for a lesion ≥40 mm were higher than for en bloc resection of a lesion < 40 mm (OR = 15.231, CI 1.816–127.744; OR = 43.043, CI 4.306–430.314). Conclusion: We found risk factors of EMR for LST and tentatively suggest a protocol for EMR adapted to the size of LST and resection methods. (i) Following piecemeal resection and en bloc resection for LST ≥ 40 mm, hospitalize patients for 36 h and note risk for incomplete resection and delayed bleeding. (ii) After en bloc resection for 40 mm > LST ≥ 30 mm, hospitalize patients for 12 h and note risk for incomplete resection. (iii) Following en bloc resection for LST < 30 mm, hospitalize the patient for 12 h and expect complete resection.