Abstract：
OBJECTIVE: There is growing evidence for the role of cold piecemeal endoscopic mucosal resection (C-EMR) in the treatment of colorectal lesions ≥10mm. However, it is unclear if it is equally efficacious for all histologic subtypes and sizes. This retrospective study compares the efficacy and safety of C-EMR in the resection of medium (10-19mm) and large (≥20mm) serrated and adenomatous lesions.
METHODS: A retrospective analysis was performed of Paris IIa colonic lesions resected utilising a C-EMR technique over a 3.5 year period at our center.
RESULTS: C-EMR was performed for 242 lesions in 151 patients. Lesion size ranged between 10mm to 50mm, with median size of 20mm. Ninety-five polyps were adenomatous, with 147 sessile serrated lesions (SSLs). At six month surveillance colonoscopy, the combined recurrence rate was 6.2%. Adenomas ≥20mm demonstrated a higher rate of recurrence (16.1%) compared to large SSLs (4.1%), medium adenomas (3.0%), and medium SSLs (1.4%). There were no adverse events reported following C-EMR.
CONCLUSIONS: C-EMR seems to be less effective for the resection of large adenomas when compared to medium adenomas or large SSLs. C-EMR is equally safe for all lesion size and histology.
METHODS: A retrospective analysis was performed of Paris IIa colonic lesions resected utilising a C-EMR technique over a 3.5 year period at our center.
RESULTS: C-EMR was performed for 242 lesions in 151 patients. Lesion size ranged between 10mm to 50mm, with median size of 20mm. Ninety-five polyps were adenomatous, with 147 sessile serrated lesions (SSLs). At six month surveillance colonoscopy, the combined recurrence rate was 6.2%. Adenomas ≥20mm demonstrated a higher rate of recurrence (16.1%) compared to large SSLs (4.1%), medium adenomas (3.0%), and medium SSLs (1.4%). There were no adverse events reported following C-EMR.
CONCLUSIONS: C-EMR seems to be less effective for the resection of large adenomas when compared to medium adenomas or large SSLs. C-EMR is equally safe for all lesion size and histology.
摘要：
目的：越来越多的证据表明，冷片内镜黏膜切除术（C-EMR）在治疗≥10mm的结直肠病变中的作用。然而,目前尚不清楚它对所有组织学亚型和大小是否同样有效.这项回顾性研究比较了C-EMR在切除中型（10-19mm）和大型（≥20mm）锯齿状和腺瘤性病变中的疗效和安全性。
方法：在我们中心3.5年期间，对采用C-EMR技术切除的ParisIIa结肠病变进行了回顾性分析。
结果：对151例患者的242个病灶进行了C-EMR。病变大小在10mm到50mm之间，中值尺寸为20mm。95个息肉是腺瘤，147个无柄锯齿状病变（SSLs）。在六个月的结肠镜检查时，合并复发率为6.2%.与大SSLs（4.1％）相比，≥20mm的腺瘤显示出更高的复发率（16.1％），中度腺瘤（3.0%），和中等SSL（1.4%）。C-EMR后未报告不良事件。
结论：与中型腺瘤或大型SSLs相比，C-EMR似乎对大型腺瘤的切除效果较差。C-EMR对于所有病变大小和组织学同样安全。
方法：在我们中心3.5年期间，对采用C-EMR技术切除的ParisIIa结肠病变进行了回顾性分析。
结果：对151例患者的242个病灶进行了C-EMR。病变大小在10mm到50mm之间，中值尺寸为20mm。95个息肉是腺瘤，147个无柄锯齿状病变（SSLs）。在六个月的结肠镜检查时，合并复发率为6.2%.与大SSLs（4.1％）相比，≥20mm的腺瘤显示出更高的复发率（16.1％），中度腺瘤（3.0%），和中等SSL（1.4%）。C-EMR后未报告不良事件。
结论：与中型腺瘤或大型SSLs相比，C-EMR似乎对大型腺瘤的切除效果较差。C-EMR对于所有病变大小和组织学同样安全。
