Author/Authors :
Arimoto, Jun Department of Gastroenterology - Omori Red Cross Hospital, Tokyo, Japan , Higurashi, Takuma Department of Gastroenterology and Hepatology - Yokohama City University School of Medicine, Yokohama, Japan , Chiba, Hideyuki Department of Gastroenterology - Omori Red Cross Hospital, Tokyo, Japan , Misawa, Noboru Department of Gastroenterology and Hepatology - Yokohama City University School of Medicine, Yokohama, Japan , Yoshihara, Tsutomu Department of Gastroenterology and Hepatology - Yokohama City University School of Medicine, Yokohama, Japan , Kato, Takayuki Department of Gastroenterology and Hepatology - Yokohama City University School of Medicine, Yokohama, Japan , Kanoshima, Kenji Department of Gastroenterology and Hepatology - Yokohama City University School of Medicine, Yokohama, Japan , Fuyuki, Akiko Department of Gastroenterology and Hepatology - Yokohama City University School of Medicine, Yokohama, Japan , Ohkubo, Hidenori Department of Gastroenterology and Hepatology - Yokohama City University School of Medicine, Yokohama, Japan , Nonaka, Takashi Department of Gastroenterology - National Yokohama Medical Center, Yokohama, Japan , Sato, Takamitsu Department of Gastroenterology and Hepatology - Yokohama City University School of Medicine, Yokohama, Japan , Sakai, Eiji Department of Gastroenterology - Kanto Medical Center NTT EC, Tokyo, Japan , Iida, Hiroshi Department of Gastroenterology and Hepatology - Yokohama City University School of Medicine, Yokohama, Japan , Goto, Tohru Department of Gastroenterology - Omori Red Cross Hospital, Tokyo, Japan , Nakajima, Atsushi Department of Gastroenterology and Hepatology - Yokohama City University School of Medicine, Yokohama, Japan
Abstract :
Background/Aims
The “Resect and Discard” strategy is a potentially useful strategy. At present, only the lesion size and accuracy of diagnosis are cited as considerations for clinical adoption of this strategy. On the other hand, histopathology of the resected specimens after Endoscopic Mucosal Resection (EMR) reveals often an unclear or positive-margin status, implying Incomplete Polyp Resection (IPR). If IPR indeed increased the risk of local recurrence, histopathological evaluation of the margin would be indispensable and clinical adoption of this strategy is difficult. The aim of this study is to verify the association between IPR and the risk of local recurrence.
Methods
The 1872 polyps and 603 EMR cases in 597 patients who had EMR between May 2013 and May 2014 were enrolled. The local recurrence rate until 3 years after the EMR in cases with the target lesions of the “Resect and Discard” strategy was determined in the negative-margin and IPR groups.
Results
The final analysis was performed using the data of 1092 polyps, and 222 were categorized into the IPR group. There were no cases of recurrence in either of the groups.
Conclusion
This is the world's first report conducted to examine the correlation of IPR and the local recurrence rate for clinical practice of “Resect and Discard” strategy. There is the possibility that pathological evaluation of the margins after EMR in patients with small polyps can be skipped.
