Safety of endoscopic mucosal resection (EMR) of large non-pedunculated colorectal adenomas in the elderly

Autor: Jelle F. Huisman, B. E. Schenk, W. H. de Vos tot Nederveen Cappel, Alexandra M. J. Langers, Jurjen J. Boonstra, James C. H. Hardwick, Hans F. A. Vasen, K. Bronsgeest
Rok vydání: 2017
Předmět:
Male
Time Factors
Complications
Blood Loss
Surgical
Endoscopic mucosal resection
Gastroenterology
Antithrombotic treatment
Adenomatous Polyps
0302 clinical medicine
Elderly
Risk Factors
Antithrombotic
Giant adenomas
Netherlands
EMR
Age Factors
Middle Aged
Tumor Burden
Treatment Outcome
030220 oncology & carcinogenesis
030211 gastroenterology & hepatology
Female
Original Article
Colorectal adenomas
Colorectal Neoplasms
Non-pedunculated adenomas
medicine.medical_specialty
Endoscopic Mucosal Resection
Perforation (oil well)
Colonic Polyps
Postoperative Hemorrhage
Drug Administration Schedule
03 medical and health sciences
Fibrinolytic Agents
Internal medicine
medicine
Humans
In patient
Aged
Retrospective Studies
Perforations
business.industry
Significant difference
Bleeding
Retrospective cohort study
digestive system diseases
Surgery
Intestinal Perforation
Complication
business
Zdroj: International Journal of Colorectal Disease
International Journal of Colorectal Disease, 32(12), 1711-1717
ISSN: 1432-1262
Popis: Background Endoscopic mucosal resection (EMR) has been proven to be safe and effective for the treatment of colorectal adenomas. However, data are limited on the safety of this technique for large polyps and in elderly patients. Aims of our study were to examine the bleeding and perforation rates in patients with large non-pedunculated adenomas (≥20mm) and to evaluate the influence of size (≥40mm) and age (≥75 years) on the complication rates. Methods In this multicenter retrospective study, patients who underwent EMR of non-pedunculated adenomas ≥20mm between January 2012 and March 2016 were included. The demographics of the patients, the use of antithrombotic drugs, size of the polyps, type of resection, pathology report, occurrence of post-polypectomy bleeding, and perforation- and recurrence rate were collected. Results In 343 patients, 412 adenomas were removed. Eighty patients (23.3%) were ≥75 years of age, 138 polyps (33.5%) were ≥40mm. Bleeding complications were observed in 28 cases (6.8%) and were found significantly more frequent in adenomas ≥40mm, independent of the use of antithrombotic therapy. Five perforations (1.2%) were described, not related to the size of the polyp. There was no significant difference in complication rates between patients
Databáze: OpenAIRE
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