Authors: Seon Hee Lim John M Levenick Abraham Mathew Matthew T Moyer Charles E Dye Thomas J McGarrity
Publish Date: 2016/10/01
Volume: 61, Issue: 12, Pages: 3572-3583
Abstract
A retrospective review of patients referred for large ≥20 mm NP polyp management from January 2010 through June 2014 was completed Polyp morphology was classified as either a NP polyp with depression M1 or NP polyp with no depression M0 Differences in treatment histology adverse events outcomes at followup including residual disease and need for surgical treatment were determined by morphology for all NP polyps ≥20 mm in sizeOnehundred and sixtynine M1 and 136 M0 polyps ≥20 mm were removed endoscopically during the review period Mean size was 319 ± 110 mm in M1 and 268 ± 95 mm in M0 group p 00001 En bloc resection was possible in 183 of M1 and 309 of M0 lesions p = 0011 with endoscopic submucosal dissection used in 13 and 22 of polyps respectively p 00001 Residual polyp was found in 265 27/102 of M1 and 136 12/88 of M0 patients at surveillance colonoscopy p = 0029 On multivariate analysis piecemeal resection and M1 morphology showed significant association with residual polyp OR 423 95 CI 123–1459 p = 0022 and OR 215 95 CI 1004–462 p = 0049 respectivelyEffective endoscopic management of large NP colorectal polyps especially polyps without depression M0 can be accomplished in the great majority of patients Polyp morphology particularly the presence or absence of depression is a useful tool which influenced treatment histology and outcomes
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