The role of endoscopic mucosal resection in gastrointestinal precancerous lesions

Abstract

Objectives: Endoscopic mucosal resection (EMR) hasbeen widely used in early gastrointestinal malignancies andprecancerous lesions. We aim to analyze the outcomes of EMR forgastrointestinal precancerous lesions.Materials and Methods: A total of 1,518 cases wereretrospectively analyzed. Of these, 59 patients had undergoneEMR for gastrointestinal lesions. The lesions were divided intotwo subgroups according to size; smaller than 20 mm and equal orlarger than 20 mm. The mucosal aspect (Kudo pit pattern), Parisclassification of the resected lesions and recurrences that weredetermined during close follow-up were recorded.Results: A total of 94 polyps were resected in 59 patients.En-block resection was performed in 42 (71.2%) patients andpiecemeal resection in 17 (28.8%). There was no significantdifference between two modalities; regarding age, gender,histopathology, complications, recurrence or macroscopic type(P>0.05). However, the occurrence of Kudo type 4 lesions andadenomatous polyps (P=0.001) was significant in the >20 mmgroup (P=0.03).Conclusion: Endoscopic mucosal resection is a safe andfeasible procedure for precancerous lesions, with low complicationand acceptable recurrence rates. Additionally, the Kudo pit patternshould be taken into consideration on a routine basis whendetermining the risk of cancer.