Outcomes of endoscopic resection of large colorectal lesions subjected to prior failed resection or substantial manipulation

Purpose Injudicious attempts at resection and extensive sampling of large colorectal adenomas prior to referral for endoscopic resection (ER) are common. This has deleterious effects, but little is known about the outcomes following ER. We retrospectively analysed the outcomes of ER of large adenoma...

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Bibliographic Details
Published in:International journal of colorectal disease 2019-06, Vol.34 (6), p.1033-1041
Main Authors: Emmanuel, Andrew, Gulati, Shraddha, Burt, Margaret, Hayee, Bu’Hussain, Haji, Amyn
Format: Article
Language:English
Subjects:
Biopsy
Endoscopy
Gastroenterology
Hepatology
Internal Medicine
Medicine
Medicine & Public Health
Original Article
Patients
Proctology
Surgery
Tumors
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Summary:Purpose Injudicious attempts at resection and extensive sampling of large colorectal adenomas prior to referral for endoscopic resection (ER) are common. This has deleterious effects, but little is known about the outcomes following ER. We retrospectively analysed the outcomes of ER of large adenomas previously subjected to substantial manipulation. Method ER of large (≥ 2 cm) colorectal adenomas were grouped according to level of manipulation: prior attempted resection, heavy manipulation (≥ six biopsies or tattoo under lesion) or minimal manipulation ( 95% of patients overall free from recurrence and avoiding surgery at last follow-up. Conclusion There is a substantial burden of injudicious lesion manipulation before referral, which makes recurrence more likely and en bloc resection less likely. However, with appropriate expertise, sustained successful endoscopic treatment is achievable for the vast majority of patients treated in a specialist unit.
ISSN:0179-1958
1432-1262
DOI:10.1007/s00384-019-03285-3