Open AccessRisk factors for colon adenomas recurrence after endoscopic mucosal resection
Author(s) -
Ю. Е. Ваганов,
В. В. Веселов,
А. А. Ликутов,
Е. А. Хомяков,
С. В. Чернышов,
Э. У. Абдулжалиева,
С. И. Ачкасов
Publication year - 2021
Publication title -
koloproktologiâ
Language(s) - English
Resource type - Journals
eISSN - 2686-7303
pISSN - 2073-7556
DOI - 10.33878/2073-7556-2021-20-1-10-16
Subject(s) - medicine , surgery , endoscopic mucosal resection , dysplasia , retrospective cohort study , complication , polypectomy , adenoma , endoscopy , gastroenterology , colonoscopy , colorectal cancer , cancer
Aim : to identify risk factors for neoplasms recurrence removed by endoscopic mucosal resection (EMR). Patients and methods : the single-center retrospective observational study included 207 patients with 260 benign colon neoplasms. There were 95 (45.9%) males and 112 (54.1%) females. The median age of the patients was 67 (27-80) years. The results obtained were assessed using following criteria: morbidity rate, complication type, hospital stay, tumor site, number of neoplasms in colon, lateral growth, fragmentation rate, technical difficulties (mucosal fold convergence)during surgery, grade of dysplasia, recurrence rate. Results : intraoperative fragmentation of the neoplasms during mucosectomy occurred in 48/260 (18.5%) cases. Postoperative complications within the period of up to 30 days occurred in 13/207 (6.3%) patients. The most frequent 9 (4.2%) postoperative complication arising after mucosectomy was post-polypectomy syndrome. Another 4 (2.0%) patients produced bleeding after the surgery, which required repeated endoscopic procedure. No mortality occurred. The tumor size exceeding 25 mm (Exp (B) = 0.179; 95% CI = 0.05-0.7; p = 0.014), severe dysplasia (Exp (B) = 0.113; 95% CI = 0.03-0.4; p = 0.001) and fold convergence (Exp (B) = 0.2; 95% CI = 0.07-0.7; p = 0.015) are independent risk factors for disease recurrence. Conclusion : mucosectomy is indicated for colon adenomas if its size does not exceed 25 mm and can be removed en bloc.