Endoscopic mucosal resection and conventional polypectomy in colon adenomas
https://doi.org/10.33878/2073-7556-2021-20-2-29-34
Abstract
Aim: to compare the early and long-term results of endoscopic mucosal resection (EMR) and conventional polypectomy for benign epithelial colon neoplasms
Patients and methods: the retrospective study included 344 patients with histologically verified adenomas of the size of up to 40 mm in the colon, who underwent EMR or conventional polypectomy. Mucosectomy (EMR) was performed in 207 patients, while conventional polypectomy was performed in 137.
Results: there were no significant differences in the postoperative morbidity rates between the methods (OR = 1.8; 95% CI = 0.7–4.8, p = 0.3). Fragmentation significantly more often occurred in the group of conventional polypectomy (OR = 3.5; 95% CI = 2.3–5.5, p = 0.001, especially when the size of the neoplasm was over 1 cm (OR = 3.1; 95% CI = 1.1–8.9 = 0.037). Recurrence occurred in 19/173 (10.9%) in 12 (8.3%) patients of the EMR group. In the polypectomy group, recurrence developed in 22 (23.1%) patients, in 24/108 (22.2%) cases at the site of the postoperative scar. It was found that the adenoma recurrence in the area of endoscopic excision occurs significantly more often after conventional polypectomy (OR = 2.3; 95% CI = 1.2–4.4; p = 0.016).
Conclusion: EMR and conventional polypectomy both are the safe methods with low morbidity rates. However, the EMR is the preferred method of endoscopic excision for adenomas larger than 1 cm due to the fact that it allows for deeper and more complete resection of the tissue than conventional polypectomy.
About the Authors
Yu. E. Vaganov
Ryzhikh National Medical Research Center of Coloproctology
Russian Federation
Russian Federation
Yuri E. Vaganov
Salyama Adilya str., 2, Moscow, 123423, Russia
E. A. Khomyakov
Ryzhikh National Medical Research Center of Coloproctology; Russian Medical Academy of Continuous Professional Education of the Ministry of Healthcare of Russia
Russian Federation
Russian Federation
Eugeniy A. Khomyakov
Salyama Adilya str., 2, Moscow, 123423, Russia,
Barrikadnaya str., 2/1–1, Moscow, Russia
A. B. Serebry
Ryzhikh National Medical Research Center of Coloproctology
Russian Federation
Russian Federation
Alyona B. Serebry
Salyama Adilya str., 2, Moscow, 123423, Russia
E. U. Abdulzhalieva
Ryzhikh National Medical Research Center of Coloproctology
Russian Federation
Russian Federation
Elmira U. Abdulzhalieva
Salyama Adilya str., 2, Moscow, 123423, Russia
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Review
For citations:
Vaganov Yu.E., Khomyakov E.A., Serebry A.B., Abdulzhalieva E.U. Endoscopic mucosal resection and conventional polypectomy in colon adenomas. Koloproktologia. 2021;20(2):29-34. https://doi.org/10.33878/2073-7556-2021-20-2-29-34
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