| Theme | Indication and limitation of endoscopic mucosal resection in colorectal neoplasia | |
|---|---|---|
| Title | A study on the indications for and limitations of EMR for the problems associated with remnant lesions | |
| Publish Date | 1998/11 | |
| Author | Masahiro Igarashi | Kitasato University East Hospital, Department of Internal Medicine |
| [ Summary ] | The purpose of this study was to investigate indications for and limitations of endoscopic mucosal resection (EMR) and problems with remnant lesions. We noted 1,655 lesions by performing EMR procedures during 1988 to 1997. The incidence of carcinoma was 11.4% of all lesions. Four remnant lesions were seen in patients with early colorectal cancer and the incidence in this case was 2.1%. The characteristics of high risk of remnant lesions of the ascending colon, were nodule-aggregating lesions, or sm cancer with a size of over 21mm in diameter. However, lesions under 3cm in diameter were removed safely, using EMR. Piecemeal polypectomy had a higher incidence of the remnant lesions than enbloc resection. The remnant rate was 11.1% in the resected margin positive lesions. Remnant lesions were diagnosed by dye scattering or magnifying endoscopic observations. Additional procedures were very useful in protecting the patient from remnant lesions. It was concluded that EMR is indicated in treat-ment of m and sm slightly invasive cancer when the size is under 3 cm in diameter. |
|