The role of endoscopic mucosal resection in gastrointestinal precancerous lesions

Abstract

Objectives: Endoscopic mucosal resection (EMR) has been widely used in early gastrointestinal malignancies and precancerous lesions. We aim to analyze the outcomes of EMR for gastrointestinal precancerous lesions. Materials and Methods: A total of 1,518 cases were retrospectively analyzed. Of these, 59 patients had undergone EMR for gastrointestinal lesions. The lesions were divided into two subgroups according to size; smaller than 20 mm and equal or larger than 20 mm. The mucosal aspect (Kudo pit pattern), Paris classification of the resected lesions and recurrences that were determined 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 and piecemeal resection in 17 (28.8%). There was no significant difference between two modalities; regarding age, gender, histopathology, complications, recurrence or macroscopic type (P>0.05). However, the occurrence of Kudo type 4 lesions and adenomatous polyps (P=0.001) was significant in the >20 mm group (P=0.03). Conclusion: Endoscopic mucosal resection is a safe and feasible procedure for precancerous lesions, with low complication and acceptable recurrence rates. Additionally, the Kudo pit pattern should be taken into consideration on a routine basis when determining the risk of cancer.