Endoscopic mucosal resection of large hyperplastic polyps in 3 patients with Barrett&rsquo;s esophagus

doi:10.3748/wjg.v12.i35.5699

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Sep 21, 2006 (publication date) through Nov 2, 2024

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World Journal of Gastroenterology

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1007-9327

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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World J Gastroenterol. Sep 21, 2006; 12(35): 5699-5704
Published online Sep 21, 2006. doi: 10.3748/wjg.v12.i35.5699

Endoscopic mucosal resection of large hyperplastic polyps in 3 patients with Barrett’s esophagus

Antonella De Ceglie, Gabriella Lapertosa, Sabrina Blanchi, Marcello Di Muzio, Massimo Picasso, Rosangela Filiberti, Francesco Scotto, Massimo Conio

Antonella De Ceglie, Francesco Scotto, Department of Gastroenterology, National Cancer Institute, Bari, Italy

Gabriella Lapertosa, Department of Surgical and Morphological Sciences, Division of Pathology, University of Genova, Genova, Italy

Marcello Di Muzio, Department of Pathology, General Hospital, Sanremo, Italy

Rosangela Filiberti, Division of Enviromental Epidemiology and Biostatistics, National Cancer Research Institute, Genova, Italy

Sabrina Blanchi, Massimo Picasso, Massimo Conio, Department of Gastroenterology, General Hospital, Sanremo, Italy

Author contributions: All authors contributed equally to the work.

Correspondence to: Massimo Conio, MD, Corso Garibaldi 187, Sanremo (IM) 3 18038, Italy. mxconio@tin.it

Telephone: +39-184-536873 Fax: +39-184-536875

Received: February 9, 2006
Revised: February 12, 2006
Accepted: February 28, 2006
Published online: September 21, 2006

Abstract

AIM: To report the endoscopic treatment of large hyperplastic polyps of the esophagus and esophago-gastric junction (EGJ) associated with Barrett’s esophagus (BE) with low-grade dysplasia (LGD), by endoscopic mucosal resection (EMR).

METHODS: Cap fitted EMR (EMR-C) was performed in 3 patients with hyperplastic-inflammatory polyps (HIPs) and BE.

RESULTS: The polyps were successfully removed in the 3 patients. In two patients, with short segment BE (SSBE) (≤ 3 cm), the metaplastic tissue was completely excised. A 2 cm circumferential EMR was performed in one patient with a polyp involving the whole EGJ. A simultaneous EMR-C of a BE-associated polypoid dysplastic lesion measuring 1 cm x 10 cm, was also carried out. In the two patients, histologic assessment detected LGD in BE. No complications occurred. Complete neosquamous re-epithelialization occurred in the two patients with SSBE. An esophageal recurrence occurred in the remaining one and was successfully retreated by EMR.

CONCLUSION: EMR-C appears to be a safe and effective method for treating benign esophageal mucosal lesions, allowing also the complete removal of SSBE.

Keywords: Hyperplastic polyps; Endoscopic mucosal resection; Barrett’s esophagus