Resection will usually follow a submucosal saline injection (saline assisted polypectomy). Foremost for flat adenoma, the resection by snares piece by piece, the so-called piecemeal polypectomy, or piecemeal endoscopic mucosal resection (EMR), is state of the art. If the size of adenoma is larger than 2 cm, resections are usually done in a hospital setting. Currently, colonoscopy is the best way to detect bowel tumors and polyps, since these can be biopsied and removed in one working process. In 20 to 35% of colonoscopies due to symptoms or for prevention polyps, so-called adenoma, are found. Procedure: en-bloc resection Procedure: piecemeal resection Condition or diseaseĬolorectal Adenoma With Mild Dysplasia Colorectal Adenoma With Severe Dysplasia Colorectal Adenomatous Polyp Colorectal Low Grade Intraepithelial Neoplasia Colorectal High Grade Intraepithelial Neoplasia The study might have influence on the logistics of future adenoma processing and patient flow. This study is the first one ever to compare piecemeal EMR and ESD in a randomized way. The data situation regarding safety and efficacy of both therapies is low. They have higher complication rates especially in the West, where it has bee introduced only a couple of years ago. En-bloc resections, though, are expected to have less recurrence rates but are much more complex to perform. Both resection techniques are done usually by previous injection of saline or other liquids to elevate the lesion from its bottom tissue.Īlthough the piecemeal resection of large adenoma is the standard therapy, it shows recurrence rates of 10 to 25%, which afford repeated therapies and follow up controls. For this kind of therapy, different endoscopic knifes are use to cut off the adenoma as a whole. This is done by the so-called en-bloc resection. Therefore these adenomas should be resected in one piece. This technique is the standard therapy, but is not required for very large adenomas, which can often show cell alterations that indicate cancer. The so-called piecemeal resection is done with snares, to cut off parts of the adenoma piece by piece until the whole adenoma is resected.
For the resection of large adenomas, different approaches can be used. If the size of adenomas is larger than 2 cm, resections are usually done in a hospital setting. Why Should I Register and Submit Results?Ĭurrently, colonoscopy is the safest way to detect bowel tumors and polyps, since these can be biopsied and removed in one working process.
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