PMID- 25012560
OWN - NLM
STAT- MEDLINE
DCOM- 20150720
LR  - 20220318
IS  - 1097-6779 (Electronic)
IS  - 0016-5107 (Linking)
VI  - 80
IP  - 6
DP  - 2014 Dec
TI  - Underwater endoscopic mucosal resection for recurrences after previous piecemeal 
      resection of colorectal polyps (with video).
PG  - 1094-102
LID - S0016-5107(14)01808-2 [pii]
LID - 10.1016/j.gie.2014.05.318 [doi]
AB  - BACKGROUND: Conventional endoscopic treatment of a recurrent adenoma after 
      piecemeal EMR (PEMR) of a colorectal laterally spreading tumor (LST) is 
      technically difficult with low en bloc resection rates because of the inability 
      to snare fibrotic residual. OBJECTIVE: To assess the feasibility of salvage 
      underwater EMR (UEMR) for the treatment of recurrent adenoma after PEMR of a 
      colorectal LST. DESIGN: Retrospective, cross-sectional study. SETTING: Single, 
      tertiary-care referral center. PATIENTS: Patients who have recurrent adenoma 
      after PEMR of colorectal LST (>/=2 cm). INTERVENTIONS: UEMR versus EMR. MAIN 
      OUTCOME MEASUREMENT: En bloc resection rate, endoscopic complete removal rate, 
      recurrence rate on follow-up colonoscopy, adjunctive ablation rate with argon 
      plasma coagulation (APC) during salvage procedure, and independent predictive 
      factors for successful en bloc resection and endoscopic complete removal. 
      RESULTS: Eighty salvage procedures (36 UEMRs vs 44 EMRs) were analyzed. En bloc 
      resection rate (47.2% vs 15.9%, P = .002) and endoscopic complete removal rate 
      (88.9% vs 31.8%, P < .001) were higher in the UEMR group than in the EMR group. 
      APC ablation of visible residual during salvage procedure was lower in UEMR group 
      than EMR group (11.1% vs 65.9%, P < .001). Recurrence rate on follow-up 
      colonoscopy was significantly lower in the UEMR group than the EMR group (10% vs 
      39.4%, P = .02). UEMR was an independent predictor of successful en bloc 
      resection and endoscopic complete removal. LIMITATIONS: Retrospective, 
      single-center study. CONCLUSIONS: UEMR can be a useful and feasible technique as 
      a salvage procedure for recurrent colorectal adenoma after PEMR.
CI  - Published by Elsevier Inc.
FAU - Kim, Hyun Gun
AU  - Kim HG
AD  - Institute for Digestive Research, Soonchunhyang University College of Medicine, 
      Seoul, South Korea.
FAU - Thosani, Nirav
AU  - Thosani N
AD  - Department of Gastroenterology, Stanford University School of Medicine, Stanford, 
      California, USA.
FAU - Banerjee, Subhas
AU  - Banerjee S
AD  - Department of Gastroenterology, Stanford University School of Medicine, Stanford, 
      California, USA.
FAU - Chen, Ann
AU  - Chen A
AD  - Department of Gastroenterology, Stanford University School of Medicine, Stanford, 
      California, USA.
FAU - Friedland, Shai
AU  - Friedland S
AD  - Department of Gastroenterology, Stanford University School of Medicine, Stanford, 
      California, USA; VA Palo Alto Health Care System, Palo Alto, California, USA.
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Video-Audio Media
DEP - 20140708
PL  - United States
TA  - Gastrointest Endosc
JT  - Gastrointestinal endoscopy
JID - 0010505
RN  - 059QF0KO0R (Water)
SB  - IM
MH  - Adenoma/surgery
MH  - Adenomatous Polyps/*surgery
MH  - Aged
MH  - Colonoscopy/*methods
MH  - Colorectal Neoplasms/*surgery
MH  - Cross-Sectional Studies
MH  - Feasibility Studies
MH  - Female
MH  - Humans
MH  - Intestinal Mucosa/*surgery
MH  - Male
MH  - Middle Aged
MH  - Neoplasm Recurrence, Local/*surgery
MH  - Neoplasm, Residual
MH  - Retrospective Studies
MH  - Salvage Therapy/methods
MH  - *Water
EDAT- 2014/07/12 06:00
MHDA- 2015/07/21 06:00
CRDT- 2014/07/12 06:00
PHST- 2014/03/15 00:00 [received]
PHST- 2014/05/18 00:00 [accepted]
PHST- 2014/07/12 06:00 [entrez]
PHST- 2014/07/12 06:00 [pubmed]
PHST- 2015/07/21 06:00 [medline]
AID - S0016-5107(14)01808-2 [pii]
AID - 10.1016/j.gie.2014.05.318 [doi]
PST - ppublish
SO  - Gastrointest Endosc. 2014 Dec;80(6):1094-102. doi: 10.1016/j.gie.2014.05.318. 
      Epub 2014 Jul 8.