Endoscopic Mucosal Resection with Circumferential Mucosal Incision for Colorectal Neoplasms: Comparison with Endoscopic Submucosal Dissection and between Two Endoscopists with Different Experiences
Clinical Endoscopy 2017³â 50±Ç 4È£ p.379 ~ p.387
¾çµ¿ÈÆ(Yang Dong-Hoon) - University of Ulsan College of Medicine Asan Medical Center Department of Gastroenterology
°û¹Î¼·(Kwak Min-Seob) - University of Ulsan College of Medicine Asan Medical Center Department of Gastroenterology
¹Ú»óÇü(Park Sang-Hyoung) - University of Ulsan College of Medicine Asan Medical Center Department of Gastroenterology
¿¹º´´ö(Ye Byong-Duk) - University of Ulsan College of Medicine Asan Medical Center Department of Gastroenterology
º¯Á¤½Ä(Byeon Jeong-Sik) - University of Ulsan College of Medicine Asan Medical Center Department of Gastroenterology
¸í½ÂÀç(Myung Seung-Jae) - University of Ulsan College of Medicine Asan Medical Center Department of Gastroenterology
¾ç¼®±Õ(Yang Suk-Kyun) - University of Ulsan College of Medicine Asan Medical Center Department of Gastroenterology
±èÇö°Ç(Kim Hyun-Gun) - Soonchunhyang University College of Medicine Institute for Digestive Research
(Friedland Shai) - Stanford University School of Medicine Department of Gastroenterology and Hepatology
Abstract
Background/Aims: Endoscopic mucosal resection with circumferential mucosal incision (CMI-EMR) may offer benefits comparable to those of endoscopic submucosal dissection (ESD), while requiring less technical proficiency than ESD.
Methods: We retrospectively compared the outcomes of CMI-EMR (n=34) and size-matched ESD (n=102), which were performed by a Korean endoscopist for colorectal epithelial lesions of 20?35 mm. Procedural parameters of CMI-EMRs performed by an American ESD novice (n=30) were compared with those performed by the Korean endoscopist.
Results: The lesion size was 22.3¡¾3.9 mm and 22.9¡¾2.4 mm in the CMI-EMR and size-matched ESD groups, respectively (p=0.730). The resection time was 12.7¡¾7.0 minutes in the CMI-EMR group and 45.6¡¾30.1 minutes in the ESD group (p<0.001). The en bloc resection rate was 94.1% in the CMI-EMR group and 100% in the ESD group (p=0.061). There were no differences in the en bloc resection and complication rates of CMI-EMRs between a Korean and an American endoscopist.
Conclusions
For the treatment of moderate-size colorectal lesions, CMI-EMR showed a trend toward lower en bloc resection rate, but required shorter procedure time than ESD. CMI-EMR outcomes were similar when performed by a Korean ESD expert and an American ESD novice.
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Neoplasms, Colon, Rectum, Endoscopic mucosal resection, Endoscopic submucosal dissection
KMID :
1038120170500040379
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comparising between circumferential mucosal incision (CMI-EMR) and endoscopic submucosal dissection (ESD) was similar in terms of outcomes.