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Research article
John Maynard Levenick
Penn State College of Medicine
Corresponding Author
ORCiD: https://orcid.org/0000-0001-6203-4650
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This work is licensed under a CC BY 4.0 License. Read Full License
Background and Aims: Endoscopic mucosal resection (EMR) has become the standard for removing large colon polyps but has a 10-30% recurrence rate using standard techniques. Data shows improved recurrence rates with focal therapy of the edge of the resection base using cautery. We examine a novel technique, hybrid APC assisted EMR, which treats both the edge and the base with cautery to assess its effect on local recurrence.
Methods: We reviewed all EMRs of polyps >2cm by a single endoscopist with six month follow-up from May 2018-November 2019 using both standard EMR as well as hybrid APC assisted EMR to assess local recurrence as well complications.
Results: 48 patients with 59 polyps removed by EMR had full six month follow up with a mean age of 66.1 years of age, 45% were female. 30 polyps were removed by hybrid APC assisted EMR and 29 removed with standard EMR. Overall, 0 (0%) polyps in the h-APC arm had local recurrence while 6 (20.7%) in the standard group had histological proven local recurrence (p=0.01). Post-resection bleeding occurred in 6 patients, 2 in the hAPC arm and 4 in the standard arm (p=0.41). Conclusions: Hybrid APC assisted EMR was superior to conventional EMR for local recurrence after removal of large colon polyps and trended towards a less post-EMR bleeds.
Keywords
endoscopic mucosal resection, colon polyps, Hybrid APC
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A new preprint design is coming!
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This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Research article
John Maynard Levenick
Penn State College of Medicine
Corresponding Author
ORCiD: https://orcid.org/0000-0001-6203-4650
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
History
CURRENT STATUS: Posted
Version 1
Posted 19 Jan, 2021
No community comments so far
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Gastroenterology & Hepatology
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background and Aims: Endoscopic mucosal resection (EMR) has become the standard for removing large colon polyps but has a 10-30% recurrence rate using standard techniques. Data shows improved recurrence rates with focal therapy of the edge of the resection base using cautery. We examine a novel technique, hybrid APC assisted EMR, which treats both the edge and the base with cautery to assess its effect on local recurrence.
Methods: We reviewed all EMRs of polyps >2cm by a single endoscopist with six month follow-up from May 2018-November 2019 using both standard EMR as well as hybrid APC assisted EMR to assess local recurrence as well complications.
Results: 48 patients with 59 polyps removed by EMR had full six month follow up with a mean age of 66.1 years of age, 45% were female. 30 polyps were removed by hybrid APC assisted EMR and 29 removed with standard EMR. Overall, 0 (0%) polyps in the h-APC arm had local recurrence while 6 (20.7%) in the standard group had histological proven local recurrence (p=0.01). Post-resection bleeding occurred in 6 patients, 2 in the hAPC arm and 4 in the standard arm (p=0.41). Conclusions: Hybrid APC assisted EMR was superior to conventional EMR for local recurrence after removal of large colon polyps and trended towards a less post-EMR bleeds.
Figure 1
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