Endoscopic resection for superficial colorectal neoplasia in Italy: A prospective multicentre study.

Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver

PubMedID: 24183949

Cipolletta L, Rotondano G, Bianco MA, Buffoli F, Gizzi G, Tessari F, Italian Colorectal Endoscopic Resection (ICER) Study Group. Endoscopic resection for superficial colorectal neoplasia in Italy: A prospective multicentre study. Dig Liver Dis. 2013;.
BACKGROUND
Since there are few prospective studies on colorectal endoscopic resection to date, we aimed to prospectively assess safety and efficacy of endoscopic resection in a cohort of Italian patients.

METHODS
Prospective multicentre assessment of resection of sessile polyps or non-polypoid lesions=10mm in size or smaller (if depressed). Outcome measures included complete excision, morbidity, mortality, and residual/recurrence at 12 months.

RESULTS
Overall, 1012 resections in 928 patients were analysed (62.4% sessile polyps, 28.8% laterally spreading tumours, 8.7% depressed non-polypoid lesions). Lesions were prevalent in the proximal colon. Enbloc resection was possible in 715/1012 cases (70.7%), whereas piecemeal resection was required in 297 (29.3%). Endoscopically complete excision was achieved in 866 cases (85.6%). Adverse events occurred in 83 (8.2%), and no deaths occurred. Independent predictors of 12-month residual/recurrence were the location of the lesion in the proximal colon (OR 2.22 [95% CI 1.16-4.26]; p=0.015) and piecemeal endoscopic resection (OR 2.76 [95% CI 1.56-4.87]; p=0.0005). Limitations of the study were: potential expertise bias, no data on eligible and potentially resectable excluded lesions, high percentage of lesions<20mm, follow-up limited to 1 year.

CONCLUSION
In this registry study the endoscopic resection of colorectal lesions was safe and achieved high rates of long-term endoscopic clearance.