Vojnosanitetski pregled 2014 Volume 71, Issue 1, Pages: 33-38
https://doi.org/10.2298/VSP120424040G
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Endoscopic mucosal resection of flat and sessile colorectal adenomas: Our experience with long-term follow-ups
Grgov Saša (General Hospital Leskovac, Department of Gastroenterology and Hepatology, Leskovac)
Dugalić Predrag 
(Faculty of Medicine, Clinical Hospital Centre Zemun, Department of Gastroenterology, Belgrade)
Tomašević Ratko (Faculty of Medicine, Clinical Hospital Centre Zemun, Department of Gastroenterology, Belgrade)
Tasić Tomislav (General Hospital Leskovac, Department of Gastroenterology and Hepatology, Leskovac)
Bacground/Aim. Endoscopic mucosal resection (EMR) or mucosectomy is a
removing method of flat or sessile lesions, laterally spreading tumors and
carcinoma of the colon or the rectum limited to mucosa or the surface part of
the submucosa. The aim of the study was to estimate the efficacy and safety
of EMR in removing flat and sessile colorectal adenomas. Methods. This
prospective study involved 140 patients during the period of 8 years. A total
of 187 colorectal adenomas were removed using the EMR method “inject and cut
with snare”. Results. The approximate size of mucosectomised adenomas was
13.6 mm (from 8 mm to 60 mm). There was a total of 48 (25.7%) flat adenomas
and 139 (74.3%) sessile adenomas, (p < 0.01). Using “en bloc” and “piecemeal”
resection, 173 (92.5%) and 14 (7.5%) of colorectal adenomas were removed,
respectively. In all the cases, a complete removal of colorectal adenomas was
achieved. Two (1.4%) patients had adenoma removal with intramucosal carcinoma
each. In the average follow-up period of 21.2 ± 17.8 months, 2 (1.4%)
patients had adenoma relapse after EMR. Considering complications, there was
bleeding in 1 (0.7%) patient with a big rectum adenoma removed with EMR.
Furthermore, one (0.7%) patient had a postcoagulation syndrome after cecal
adenoma was removed by EMR. Conclusion. EMR is an efficient, safe and
minimally invasive technique of removing flat and sessile adenomas in the
colon and the rectum, with a very low percentage of adenoma recurrence over a
long period of monitoring.
Keywords: adenoma, colorectal neoplasms, endoscopy, digestive system, treatment outcomes