Mendoza Ladd A, Espinoza J, Garcia C. Endoscopic mucosal ablation - an alternative treatment for colonic polyps: Three case reports. World J Gastroenterol 2020; 26(45): 7258-7262 [PMID: 33362381 DOI: 10.3748/wjg.v26.i45.7258]
Corresponding Author of This Article
Antonio Mendoza Ladd, FACG, FASGE, Assistant Professor, Department of Internal Medicine, Division of Gastroenterology, Texas Tech University Health Sciences Center, Paul L Foster School of Medicine, 4800 Alberta Avenue, El Paso, TX 79905, United States. dr_ladd25@yahoo.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastroenterol. Dec 7, 2020; 26(45): 7258-7262 Published online Dec 7, 2020. doi: 10.3748/wjg.v26.i45.7258
Endoscopic mucosal ablation - an alternative treatment for colonic polyps: Three case reports
Antonio Mendoza Ladd, Joaquin Espinoza, Cesar Garcia
Antonio Mendoza Ladd, Department of Internal Medicine, Division of Gastroenterology, Texas Tech University Health Sciences Center, Paul L Foster School of Medicine, El Paso, TX 79905, United States
Joaquin Espinoza, Escuela de Medicina Luis Razetti, Universidad Central de Venezuela, Caracas 999188, Venezuela
Cesar Garcia, Department of Endoscopy, University Medical Center of El Paso, El Paso, TX 79905, United States
Author contributions: Mendoza Ladd A performed all the procedures, edited the video, drafted, edited and approved the final manuscript; Espinoza J and Garcia C drafted, edited and approved the final manuscript.
Informed consent statement: The study was considered exempt from needing to obtain informed consent. The IRB acknowledges that this project meets the criteria for exemption from formal IRB review in accordance with 45 CFR46.104 (d)(4)(iii). A Waiver of HIPAA Authorization for Research approved under 45 CFR164.512 (i)(2)(ii).
Conflict-of-interest statement: Antonio Mendoza Ladd has received fees for serving as a consultant for CONMED; Joaquin Espinoza and Cesar Garcia no conflicts of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Antonio Mendoza Ladd, FACG, FASGE, Assistant Professor, Department of Internal Medicine, Division of Gastroenterology, Texas Tech University Health Sciences Center, Paul L Foster School of Medicine, 4800 Alberta Avenue, El Paso, TX 79905, United States. dr_ladd25@yahoo.com
Received: September 26, 2020 Peer-review started: September 26, 2020 First decision: November 8, 2020 Revised: November 9, 2020 Accepted: November 21, 2020 Article in press: November 21, 2020 Published online: December 7, 2020 Processing time: 68 Days and 11.4 Hours
Abstract
BACKGROUND
Endoscopic resection of non-invasive lesions is now the standard of care for lesions in the GI tract. However, resection techniques require extensive training, are not available in all endoscopy centers and are prone to complications. Endoscopic mucosal ablation (EMA) is a combination of resection and ablation techniques and it may offer an alternative in the management of such lesions.
CASE SUMMARY
In this case series we report the successful treatment of three flat colonic polyps using the EMA technique. Two lesions were treatment naïve and 1 was a recurrence after an endoscopic mucosal resection. The sizes ranged from 2 to 4 cm. All three polyps were ablated successfully with no immediate or delayed complications. The recurrence rate at 1 year of follow up was 0%.
CONCLUSION
Based on this initial experience, we conclude that EMA is a safe and effective technique for the treatment of non-invasive colonic polyps when endoscopic resection techniques are not available.
Core Tip: Endoscopic resection via endoscopic mucosal resection or endoscopic submucosal dissection is currently the standard of care for non-invasive colonic polyps. However, these resection techniques require extensive training, are not available in all endoscopy centers, and are prone to adverse events such as perforation and bleeding. Endoscopic mucosal ablation appears to be a safe and effective alternative in the treatment of colonic polyps without invasive features.
