Analysis of endoscopic mucosal resection in treatment of 437 patients with colorectal polyps / 中国内镜杂志

ABSTRACT

Objectives To investigate the clinical, pathological and endoscopic characteristics of colorectal polyps treated by endoscopic mucosal resection (EMR), then evaluate its therapeutic effect and security, and analyze its significance in diagnosis and treatment. Methods Clinical and pathological data of 437 patients (687 lesions), who underwent EMR from August, 2014 to August, 2015 were collected. A retrospective analysis was made, and lesions were statistically analyzed by variables such as age, sex, endoscopic features and clinical and pathological characteristics, and so on, according to the group procedure of adenoma cancerization and 'high risk adenomas - low risk adenomas - non-adenoma polyps' to observe the curative effect and safety on EMR. Results 48.28% of the patients who received colonoscopy examines were detected with polyps, and 34.90% of them were operated EMR, including advanced adenomas, which were 17.08% of the total quantity. From non-adenoma to advanced adenoma, with a increasing possibility of carcinogenesis, the location of polyps are transferred from proximal colon to distal colon and lesions are readily to be pedunculated ones with a higher level of mucosal lobulation and other kinds of mucosal changing. The degeneration of the colorectum is associated with pedunculated polyps, distal colorectal polyps, the size (>1.0 cm), adenomas containing villous structures and mucosal lobulation. As for EMR treatment, the en bloc resection rate can reach as high as 99.70%, with a complication rate of 1.14%. Conclusions Some special characteristics can be found in the site and the endoscopic feature of advanced adenomas and degenerated adenomas. To polyps sizing in 0.5 ~ 3.0 cm, EMR with endoclips has a remarkable effect and a low complication incidence. It can reduce the process of colorectal adenoma degenerates to multiple colorectal adenocarcinoma, which can be regarded as an effective method to prevent and cure the colorectal carcinoma.