Long-term outcomes for Advanced Colorectal Polyps in the BowelScreen Programme.

Q3 Medicine Irish medical journal Pub Date : 2024-09-26

E Keating, J Campion, J Leyden, S Stewart, P MacMathuna, C Lahiff

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引用次数: 0

Abstract

Aims: Colonoscopies performed as part of a colorectal cancer screening programmes regularly identify large non-pedunculated colorectal polyps (LNPCPs). Endoscopic Mucosal Resection (EMR) is a minimally invasive endoscopic resection strategy, for effective management of LNPCPs. There is limited published data on clinical outcomes for EMR carried out within screening programmes.

Methods: A retrospective analysis of a prospectively-maintained EMR database of BowelScreen patients in a single centre over a 5 year period.

Results: Fifty-two polyps in 50 patients underwent EMR in the study period. Median polyp size was 25mm (range 20-70mm). Adenocarcinoma was identified in 7.8% of resection specimens (n 4/51). Complications were recorded in 5.7% of EMRs (n 3/52). Surveillance was completed for 87.8% (n=36/41) of eligible patients with a site-check recurrence rate of 8.3% (n 3/36). Recurrence was successfully managed endoscopically through the surveillance programme with an 18 month recurrence rate of 2.7% (n 1/36). Surgery was avoided in 92% (n 46/50) of patients undergoing EMR.

Discussion: Complex polyps identified in the colorectal cancer screening programme are effectively and definitively managed by minimally invasive endoscopic resection.. Low recurrence and complication rates underscore the value of EMR as part of a screening programme. Post-EMR surveillance identifies a small number of endoscopically manageable recurrences, with encouragingly high levels of compliance.

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肠道筛查计划中晚期大肠息肉的长期治疗效果。

目的：作为结直肠癌筛查计划一部分的结肠镜检查经常会发现大的非梗阻性结直肠息肉（LNPCPs）。内镜黏膜切除术（EMR）是一种微创内镜切除策略，可有效治疗 LNPCPs。有关在筛查项目中实施内镜黏膜切除术的临床效果的公开数据十分有限：方法：对一个中心的肠道筛查患者的前瞻性 EMR 数据库进行回顾性分析，为期 5 年：研究期间，50 名患者的 52 个息肉接受了 EMR 检查。息肉大小中位数为 25 毫米（20-70 毫米不等）。7.8%的切除标本中发现腺癌（4/51）。5.7%的EMR（3/52）有并发症记录。87.8%（n=36/41）的合格患者完成了监测，现场检查复发率为8.3%（n 3/36）。通过监测计划，复发患者在内镜下得到了成功控制，18 个月的复发率为 2.7%（n 1/36）。92%（46/50）接受内镜检查的患者避免了手术：讨论：在结直肠癌筛查项目中发现的复杂息肉可通过微创内镜切除术得到有效、明确的治疗。较低的复发率和并发症发生率凸显了作为筛查计划一部分的EMR的价值。EMR后监测发现了少量可通过内窥镜处理的复发，其依从性之高令人鼓舞。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Irish medical journal Medicine-Medicine (all)

CiteScore

1.00

自引率

0.00%

发文量

139

期刊介绍： Since its inception in 1867, the Journal of the Medical Association of Ireland and now in its present format, the Irish Medical Journal, has provided the medical community in Ireland with an invaluable service. As one of the leading biomedical publications in Ireland, it has sought to continue the education of medical students and postgraduates through scientific research, review articles and updates on contemporary clinical practices while providing an ongoing forum for medical debate. A measure of our stature is that we are listed in the Index Medicus and issued annually with a citation factor from the Institute for Scientific Information.