Adenoma recurrence after endoscopic mucosal resection: propensity score analysis of old and new colonoscopes and Sydney recurrence tool implementation
Background and study aims Risk factors for colorectal adenoma recurrence after endoscopic mucosal resection (EMR) have been well documented. We assessed the efficacy of the newer 190 colonoscope versus the standard 180 colonoscope for complete resection of lateral spreading lesions. Pati...
| Main Authors: | , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Georg Thieme Verlag KG
2018-02-01
|
| Series: | Endoscopy International Open |
| Online Access: | http://www.thieme-connect.de/DOI/DOI?10.1055/s-0043-122070 |
| _version_ | 1811310208194969600 |
|---|---|
| author | Daniela Guerrero Vinsard Pujan Kandel Lady Katherine Mejia Perez Russell L. Bingham Ryan J. Lennon Timothy A. Woodward Victoria Gomez Massimo Raimondo Ernest P. Bouras Michael B. Wallace |
| author_facet | Daniela Guerrero Vinsard Pujan Kandel Lady Katherine Mejia Perez Russell L. Bingham Ryan J. Lennon Timothy A. Woodward Victoria Gomez Massimo Raimondo Ernest P. Bouras Michael B. Wallace |
| author_sort | Daniela Guerrero Vinsard |
| collection | DOAJ |
| description | Background and study aims Risk factors for colorectal adenoma recurrence after endoscopic mucosal resection (EMR) have been well documented. We assessed the efficacy of the newer 190 colonoscope versus the standard 180 colonoscope for complete resection of lateral spreading lesions.
Patients and methods A single-center, retrospective study of patients who underwent EMR with Olympus 180 or 190 colonoscopes from January 1, 2010 to September 30, 2016. We included patients with lesions ≥ 20 mm and surveillance colonoscopy (SC1) after index EMR. A propensity score approach with inverse probability weighting was used to control for potential confounders. A secondary aim was to identify risk factors for recurrence and assess the applicability of the Sydney EMR recurrence tool (SERT) by grading each lesion of our cohort and analyzing associations with recurrence.
Results Two hundred ninety-one lesions met inclusion criteria for the study. Odds ratio (OR) for recurrence with the 190 colonoscope was 1.06 (P = .85). Adenoma size (P = .02) and use of argon plasma coagulation (APC; P < .001) were risk factors for recurrence. Lesions with SERT scores > 0 had a higher recurrence risk during follow-up (32 % vs 21 %; OR 1.71; P = .05). Lesions with SERT scores = 0 reached a plateau for recurrence at 12 and 18 months in Kaplan-Meier curves.
Conclusions The use of 190 colonoscopes did not measurably affect adenoma recurrence at SC1. Recurrence was associated with adenoma size, complementary APC for resection, and SERT scores > 0. Lesions with SERT scores = 0 that remain negative for recurrence at 18 months may return to routine surveillance. |
| first_indexed | 2024-04-13T09:54:15Z |
| format | Article |
| id | doaj.art-f994309ce3f14272b26f13f69d12c6db |
| institution | Directory Open Access Journal |
| issn | 2364-3722 2196-9736 |
| language | English |
| last_indexed | 2024-04-13T09:54:15Z |
| publishDate | 2018-02-01 |
| publisher | Georg Thieme Verlag KG |
| record_format | Article |
| series | Endoscopy International Open |
| spelling | doaj.art-f994309ce3f14272b26f13f69d12c6db2022-12-22T02:51:29ZengGeorg Thieme Verlag KGEndoscopy International Open2364-37222196-97362018-02-010602E230E24110.1055/s-0043-122070Adenoma recurrence after endoscopic mucosal resection: propensity score analysis of old and new colonoscopes and Sydney recurrence tool implementationDaniela Guerrero Vinsard0Pujan Kandel1Lady Katherine Mejia Perez2Russell L. Bingham3Ryan J. Lennon4Timothy A. Woodward5Victoria Gomez6Massimo Raimondo7Ernest P. Bouras8Michael B. Wallace9Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, Florida, United StatesDivision of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, Florida, United StatesDivision of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, Florida, United StatesDivision of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, Florida, United StatesDivision of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, Minnesota, United StatesDivision of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, Florida, United StatesDivision of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, Florida, United StatesDivision of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, Florida, United StatesDivision of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, Florida, United StatesDivision of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, Florida, United StatesBackground and study aims Risk factors for colorectal adenoma recurrence after endoscopic mucosal resection (EMR) have been well documented. We assessed the efficacy of the newer 190 colonoscope versus the standard 180 colonoscope for complete resection of lateral spreading lesions. Patients and methods A single-center, retrospective study of patients who underwent EMR with Olympus 180 or 190 colonoscopes from January 1, 2010 to September 30, 2016. We included patients with lesions ≥ 20 mm and surveillance colonoscopy (SC1) after index EMR. A propensity score approach with inverse probability weighting was used to control for potential confounders. A secondary aim was to identify risk factors for recurrence and assess the applicability of the Sydney EMR recurrence tool (SERT) by grading each lesion of our cohort and analyzing associations with recurrence. Results Two hundred ninety-one lesions met inclusion criteria for the study. Odds ratio (OR) for recurrence with the 190 colonoscope was 1.06 (P = .85). Adenoma size (P = .02) and use of argon plasma coagulation (APC; P < .001) were risk factors for recurrence. Lesions with SERT scores > 0 had a higher recurrence risk during follow-up (32 % vs 21 %; OR 1.71; P = .05). Lesions with SERT scores = 0 reached a plateau for recurrence at 12 and 18 months in Kaplan-Meier curves. Conclusions The use of 190 colonoscopes did not measurably affect adenoma recurrence at SC1. Recurrence was associated with adenoma size, complementary APC for resection, and SERT scores > 0. Lesions with SERT scores = 0 that remain negative for recurrence at 18 months may return to routine surveillance.http://www.thieme-connect.de/DOI/DOI?10.1055/s-0043-122070 |
| spellingShingle | Daniela Guerrero Vinsard Pujan Kandel Lady Katherine Mejia Perez Russell L. Bingham Ryan J. Lennon Timothy A. Woodward Victoria Gomez Massimo Raimondo Ernest P. Bouras Michael B. Wallace Adenoma recurrence after endoscopic mucosal resection: propensity score analysis of old and new colonoscopes and Sydney recurrence tool implementation Endoscopy International Open |
| title | Adenoma recurrence after endoscopic mucosal resection: propensity score analysis of old and new colonoscopes and Sydney recurrence tool implementation |
| title_full | Adenoma recurrence after endoscopic mucosal resection: propensity score analysis of old and new colonoscopes and Sydney recurrence tool implementation |
| title_fullStr | Adenoma recurrence after endoscopic mucosal resection: propensity score analysis of old and new colonoscopes and Sydney recurrence tool implementation |
| title_full_unstemmed | Adenoma recurrence after endoscopic mucosal resection: propensity score analysis of old and new colonoscopes and Sydney recurrence tool implementation |
| title_short | Adenoma recurrence after endoscopic mucosal resection: propensity score analysis of old and new colonoscopes and Sydney recurrence tool implementation |
| title_sort | adenoma recurrence after endoscopic mucosal resection propensity score analysis of old and new colonoscopes and sydney recurrence tool implementation |
| url | http://www.thieme-connect.de/DOI/DOI?10.1055/s-0043-122070 |
| work_keys_str_mv | AT danielaguerrerovinsard adenomarecurrenceafterendoscopicmucosalresectionpropensityscoreanalysisofoldandnewcolonoscopesandsydneyrecurrencetoolimplementation AT pujankandel adenomarecurrenceafterendoscopicmucosalresectionpropensityscoreanalysisofoldandnewcolonoscopesandsydneyrecurrencetoolimplementation AT ladykatherinemejiaperez adenomarecurrenceafterendoscopicmucosalresectionpropensityscoreanalysisofoldandnewcolonoscopesandsydneyrecurrencetoolimplementation AT russelllbingham adenomarecurrenceafterendoscopicmucosalresectionpropensityscoreanalysisofoldandnewcolonoscopesandsydneyrecurrencetoolimplementation AT ryanjlennon adenomarecurrenceafterendoscopicmucosalresectionpropensityscoreanalysisofoldandnewcolonoscopesandsydneyrecurrencetoolimplementation AT timothyawoodward adenomarecurrenceafterendoscopicmucosalresectionpropensityscoreanalysisofoldandnewcolonoscopesandsydneyrecurrencetoolimplementation AT victoriagomez adenomarecurrenceafterendoscopicmucosalresectionpropensityscoreanalysisofoldandnewcolonoscopesandsydneyrecurrencetoolimplementation AT massimoraimondo adenomarecurrenceafterendoscopicmucosalresectionpropensityscoreanalysisofoldandnewcolonoscopesandsydneyrecurrencetoolimplementation AT ernestpbouras adenomarecurrenceafterendoscopicmucosalresectionpropensityscoreanalysisofoldandnewcolonoscopesandsydneyrecurrencetoolimplementation AT michaelbwallace adenomarecurrenceafterendoscopicmucosalresectionpropensityscoreanalysisofoldandnewcolonoscopesandsydneyrecurrencetoolimplementation |