Retrospective Study
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Nov 6, 2020; 8(21): 5180-5187
Published online Nov 6, 2020. doi: 10.12998/wjcc.v8.i21.5180
Analysis of 234 cases of colorectal polyps treated by endoscopic mucosal resection
Lu Yu, Na Li, Xiao-­Mei Zhang, Tao Wang, Wei Chen
Lu Yu, Xiao-­Mei Zhang, Tao Wang, Wei Chen, ­Department of Gastroenterology, Maanshan Central Hospital, Maanshan 243000, Anhui Province, China
Na Li, Department of Gastroenterology, Affiliated Hospital of Southeast University, Nanjing 210009, Jiangsu Province, China
Author contributions: Yu L should be considered first author and performed the operation; Li N designed this case report; Zhang XM and Wang T wrote the paper; Chen W was responsible for sorting the data.
Institutional review board statement: The study was reviewed and approved by the Institutional Review Board of Maanshan Central Hospital.
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: No conflicts of interest.
Data sharing statement: No additional data are available.
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: Lu Yu, MD, Attending Doctor, Department of Gastroenterology, Maanshan Central Hospital, No. 27 Hudongbei Road, Huashan District, Maanshan 243000, Anhui Province, China. yulu0827@163.com
Received: July 19, 2020
Peer-review started: July 19, 2020
First decision: August 21, 2020
Revised: September 3, 2020
Accepted: September 23, 2020
Article in press: September 23, 2020
Published online: November 6, 2020
Processing time: 109 Days and 19.9 Hours
Abstract
BACKGROUND

Colorectal polyps refer to all neoplasms that protrude into the intestinal cavity. Researchers believe that 50%-70% of colorectal cancers originate from adenomatous polyps.

AIM

To investigate the endoscopic morphologic features, pathologic types, and clinical situation; evaluate the efficacy and safety of endoscopic mucosal resection (EMR); and guide clinicians in their daily practice.

METHODS

Two hundred thirty-four patients who underwent EMR in our hospital from January 1, 2018 to December 31, 2019 were recruited. Data including sex, age, endoscopic morphology of the polyps, and pathological characteristics were analyzed among groups.

RESULTS

A total of 295 polyps were resected from the 234 subjects enrolled in the study, of which 4 (1.36%) were Yamada type I. There were 75 (25.42%) type II, 101 (34.24%) type III, and 115 (38.98%) type IV adenomas. Among them, 41 were non-adenomas, 110 were low-risk adenomas, 139 were high-risk adenomas, and 5 were carcinomas. The differences in distribution were not statistically significant, with P values greater than 0.05. The risk of cancer significantly increased for polyps ≥ 1 cm in diameter (c2 = 199.825, P = 0.00). Regarding the endoscopic morphological features, congestion, erosion, and lobulation were more common on the surface morphology of high-risk adenomas and cancerous polyps (c2 = 75.257, P = 0.00), and most of them were Yamada types III and IV. In all, 6 of the 295 polyps could not be removed completely, with a one-time resection rate of 97.97%. There were two cases of postoperative bleeding and no cases of perforation, with an overall complication rate of 0.09%.

CONCLUSION

Colorectal polyps ranging from non-adenomatous polyps, low-risk adenomas, and high-risk adenomas to adenocarcinomas each has their own endoscopic features, while EMR, as a mature intervention, has good safety and operability and should be promoted clinically, especially at the primary care level.

Keywords: Colorectal polyp; Endoscopic mucosal resection; High-risk adenoma; Risk factors; Adenocarcinomas; 1,4-bis (diphenylphosphino) butane

Core Tip: Endoscopic mucosal resection is a mature intervention that has good safety and operability and is worth promoting clinically, especially at the primary care level. The timely resection of colorectal polyps, especially high-risk adenomas, can effectively halt the polyp carcinogenesis process. We resected 295 polyps, of which 4 were Yamada type I. Polyps can be divided into non-adenomas, low-risk adenomas, high-risk adenomas, and carcinomas.