Cap-assisted endoscopic mucosal resection for colorectal polyps

Massimo Conio, Sabrina Blanchi, Alessandro Repici, Corrado Ruggeri, Deborah A. Fisher, Rosa Filiberti

Research output: Contribution to journalArticle

Abstract

PURPOSE: Cap-assisted endoscopic mucosal resection has been used to treat superficial esophageal and gastric cancers. Efficacy data in the colon are limited. The aim of the study was to evaluate the safety and efficacy of this technique in the treatment of sessile polyps and lateral spreading tumors in the colorectum. METHODS: Two-hundred and fifty-five consecutive patients with sessile polyps or lateral spreading tumors ≥20 mm were treated between January 2000 and December 2007. RESULTS: A total of 146 sessile polyps and 136 lateral spreading tumors were treated with cap-assisted endoscopic mucosal resection. Complications occurred in 22 (8.6%) patients (5.5% in sessile polyps and 10.3% in lateral spreading tumors). Intraprocedural bleeding occurred in 21 (7%) of polypectomies (6% in sessile polyps and 10% in lateral spreading tumors); all were controlled endoscopically. Postcoagulation syndrome occurred in 1 patient with lateral spreading tumor. No perforation occurred. Invasive adenocarcinoma was found in 35 patients, of whom 15 underwent surgery. Endoscopic follow-up in 200 patients with 216 adenomas for a median of 12.1 months showed recurrence in 8 (4%) who were treated with resection and/or ablation. CONCLUSIONS: Cap-assisted endoscopic mucosal resection is an effective treatment for sessile polyps and lateral spreading tumors. A disadvantage of the technique is that the resection is piecemeal. Close surveillance provides the opportunity for additional tissue ablation, when required, to achieve complete lesion removal.

Original languageEnglish
Pages (from-to)919-927
Number of pages9
JournalDiseases of the Colon and Rectum
Volume53
Issue number6
DOIs
Publication statusPublished - Jun 2010

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Keywords

  • Cap
  • Endoscopic mucosal resection
  • Polyp

ASJC Scopus subject areas

  • Gastroenterology

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