Endoscopic Resection of Cecal Polyps Involving the Appendiceal Orifice: A KASID Multicenter Study
- Abstract
- BACKGROUND: Endoscopic resection of polyps located at the appendiceal orifice (AO) is challenging, and the feasibility and outcomes of endoscopic resection for cecal polyps involving AO are unconfirmed. AIMS: We evaluated the feasibility and outcomes of endoscopic resection for cecal polyps involving AO. METHODS: In this retrospective, multicenter study involving nine tertiary referral centers, we evaluated 131 patients who underwent endoscopic resection for cecal polyps involving AO. RESULTS: The median size of polyps resected was 10mm (range 3-60mm). Endoscopic mucosal resection, endoscopic piecemeal mucosal resection, and endoscopic submucosal dissection were performed in 75 (57.3%), 31 (23.7%), and 5 (3.8%) patients, respectively. The en bloc resection rate was 68.7%. Endoscopic complete resection was achieved in 123 lesions (93.9%). Intraprocedural and delayed bleeding occurred in 14 (10.7%) and three patients (2.3%), respectively, and perforation occurred in two patients (1.5%). Seven patients (5.3%) underwent additional surgery because of treatment failure or recurrence. Polyps of ≥20mm in size showed significantly higher rates of perforation and additional surgery (p<0.05), and a lower rate of en bloc resection (p<0.005). Patients with polyps involving ≥75% of AO circumference exhibited a significantly lower rate of en bloc resection (p<0.001), and significantly higher rates of surgery and recurrence (p<0.05). Recurrence during follow-up occurred in 12 patients (15.6%); polyps involving ≥75% of AO circumference were an independent risk factor for recurrence. CONCLUSION: Endoscopic resection of cecal polyps involving AO is safe and effective in select patients.
- All Author(s)
- E. M. Song
; H. J. Yang
; H. J. Lee
; H. S. Lee
; J. M. Cha
; H. G. Kim
; Y. Jung
; C. M. Moon
; B. C. Kim
; J. S. Byeon
- Issued Date
- 2017
- Type
- Article
- Keyword
- Appendix; Colonic polyps; Colonoscopy; Endoscopic mucosal resection; Endoscopic submucosal dissection
- ISSN
- 0163-2116
- Citation Title
- Digestive Diseases and Sciences
- Citation Volume
- 62
- Citation Number
- 11
- Citation Start Page
- 3138
- Citation End Page
- 3148
- Language(ISO)
- eng
- DOI
- 10.1007/s10620-017-4760-2
- URI
- http://schca-ir.schmc.ac.kr/handle/2022.oak/2283
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