caa a22 4500 44579657X CHVBK 20180317145127.0 cr unu---uuuuu 170323e20110801xx s 000 0 eng 10.1007/s10620-011-1609-y doi (NATIONALLICENCE)springer-10.1007/s10620-011-1609-y Polyp Recurrence After Endoscopic Mucosal Resection of Sessile and Flat Colonic Adenomas [Elektronische Daten] [J. Mannath, V. Subramanian, R. Singh, E. Telakis, K. Ragunath] Background: Endoscopic mucosal resection (EMR) is used for treatment of sessile and flat colonic adenomas. There is limited data comparing polyp recurrence between piecemeal and en-bloc resections. Aim: The purpose of this study was to evaluate the incidence density and predictive factors for polyp recurrence after piecemeal and en-bloc resections. Methods: Patients undergoing EMR of flat or sessile adenomas≥10mm were included. Incidence density (ID) and incidence rate ratio (IRR) of polyp recurrence were calculated. Predictive factors for recurrence were assessed by multivariate analysis using logistic regression. Results: A total of 105 patients (males 54, mean age 68) with 121 polyps were included. Sixty-seven polyps (mean size±SD, 23.3±9.2mm) were resected piecemeal and 54 polyps (mean size 14.7±5.1mm) were resected en-bloc. There were 12 recurrences in the piecemeal group and two in the en-bloc group. The ID of polyp recurrence in the piecemeal group was 13.1 (95% CI 7.43-23.03) and in the en-bloc group was 2.7 (95% CI 0.67-10.78) per 100 person-years of follow-up. Piecemeal resections were 5.5 (95% CI 1.1-30.48, P=0.045) times and flat polyps were 6.6 (95% CI 1.22-35.53, P=0.028) times more likely to result in recurrence compared to en-bloc resections and sessile polyps, respectively. In the piecemeal group, additional use of argon plasma coagulation (APC) did not affect the recurrence (OR 0.46, P=0.29). Conclusions: Piecemeal resections and flat polyps are associated with higher recurrence following EMR. Additional use of APC did not affect the recurrence rates after piecemeal resection. Springer Science+Business Media, LLC, 2011 Colonic polyps nationallicence Endoscopic mucosal resection nationallicence Polyp recurrence nationallicence Incidence density nationallicence Mannath J. Nottingham Digestive Diseases Centre and NIHR Biomedical Research Unit, Queens Medical Centre Campus, Nottingham University Hospitals NHS Trust, NG7 2UH, Nottingham, UK aut Subramanian V. Nottingham Digestive Diseases Centre and NIHR Biomedical Research Unit, Queens Medical Centre Campus, Nottingham University Hospitals NHS Trust, NG7 2UH, Nottingham, UK aut Singh R. Nottingham Digestive Diseases Centre and NIHR Biomedical Research Unit, Queens Medical Centre Campus, Nottingham University Hospitals NHS Trust, NG7 2UH, Nottingham, UK aut Telakis E. Nottingham Digestive Diseases Centre and NIHR Biomedical Research Unit, Queens Medical Centre Campus, Nottingham University Hospitals NHS Trust, NG7 2UH, Nottingham, UK aut Ragunath K. Nottingham Digestive Diseases Centre and NIHR Biomedical Research Unit, Queens Medical Centre Campus, Nottingham University Hospitals NHS Trust, NG7 2UH, Nottingham, UK aut Digestive Diseases and Sciences Springer US; http://www.springer-ny.com 56/8(2011-08-01), 2389-2395 0163-2116 56:8<2389 2011 56 10620 https://doi.org/10.1007/s10620-011-1609-y text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s10620-011-1609-y text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Mannath J. Nottingham Digestive Diseases Centre and NIHR Biomedical Research Unit, Queens Medical Centre Campus, Nottingham University Hospitals NHS Trust, NG7 2UH, Nottingham, UK aut NATIONALLICENCE 700 1- Subramanian V. Nottingham Digestive Diseases Centre and NIHR Biomedical Research Unit, Queens Medical Centre Campus, Nottingham University Hospitals NHS Trust, NG7 2UH, Nottingham, UK aut NATIONALLICENCE 700 1- Singh R. Nottingham Digestive Diseases Centre and NIHR Biomedical Research Unit, Queens Medical Centre Campus, Nottingham University Hospitals NHS Trust, NG7 2UH, Nottingham, UK aut NATIONALLICENCE 700 1- Telakis E. Nottingham Digestive Diseases Centre and NIHR Biomedical Research Unit, Queens Medical Centre Campus, Nottingham University Hospitals NHS Trust, NG7 2UH, Nottingham, UK aut NATIONALLICENCE 700 1- Ragunath K. Nottingham Digestive Diseases Centre and NIHR Biomedical Research Unit, Queens Medical Centre Campus, Nottingham University Hospitals NHS Trust, NG7 2UH, Nottingham, UK aut NATIONALLICENCE 773 0- Digestive Diseases and Sciences Springer US; http://www.springer-ny.com 56/8(2011-08-01), 2389-2395 0163-2116 56:8<2389 2011 56 10620 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer