Recurrence of sessile serrated adenomas, polyps similar to conventional adenomas after EMR
The recurrence rate after endoscopic mucosal resection of large sessile serrated adenomas or polyps was found to be comparable to the recurrence rate after endoscopic mucosal resection of conventional adenomas in a recent study.
Douglas K. Rex, MD, from Indiana University School of Medicine, and colleagues, performed a retrospective cohort study to compare the recurrence rates of large sessile serrated adenomas or polyps (SSA/Ps) and conventional adenomas after endoscopic mucosal resection (EMR). Using a prospectively maintained database, they identified 362 patients (54.1% men) with 351 conventional colorectal adenomas and 46 SSA/Ps at least 20 mm in size that were resected between January 2006 and April 2014. EMR was performed with high-definition colonoscopies using a submucosal injection of a contrast agent to define the lesion’s perimeter, and all patients had a follow-up inspection and biopsy 4 to 6 months after the procedure.
Douglas K. Rex
The investigators found the residual polyp rate was 8.7% in the SSA/Ps compared with 11.1% in the conventional adenomas. Univariate analysis demonstrated only size was predictive of residual polyp at follow-up (P = .02), as did a logistic regression analysis (OR = 1.04; 95% CI, 1.01-1.06).
“In summary, we found that EMR of large SSA/Ps performed with a submucosal contrast agent and high-definition colonoscope leads to high endoscopic cure rates at first follow-up that are comparable with those achieved with conventional adenomas,” the researchers wrote. “Endoscopists should not hesitate to undertake EMR of large SSA/Ps because of concerns identified in previous studies that SSA/Ps are associated with a high risk of incomplete resection.” – by Adam Leitenberger
Disclosure: The researchers report no relevant financial disclosures.