Endoscopic Mucosal Resection Results in the Upper Gastrointestinal System

Abstract

Purpose

Endoscopic mucosal resection (EMR) is a frequently used interventional endoscopic therapeutic procedure for the treatment of benign, premalignant and early-stage malignant lesions. The aim of this study was to evaluate cases in which EMR was applied to mucosal lesions in the upper gastrointestinal tract and to discuss these in the light of the relevant literature.

Materials

The study included 82 lesions for which EMR was performed for the diagnosis of upper gastrointestinal polyp in the gastroenterology surgery endoscopy unit between January 2015 and October 2019. The cases were evaluated in terms of age, gender, histopathology, size, morphology, location, en-bloc resection, complete endoscopic resection, complications, additional procedure, advanced histopathology and referral to surgery.

Results

The mean age of the patients was 59.03 years (28–84). When the pathological features of the lesions were identified, 52.4% were determined to be hyperplastic polyps, 15.85% neuroendocrine tumours (NET) grade 1, 6.1% inflammatory polyp, 4.87% adenomatous polyps (low grade dysplasia), 3.65% adenomatous polyps (high grade dysplasia), 3.65% chronic gastritis, 2.44% were invasive adenocarcinoma, 1.22% gastritis cystica polyposis, 1.22% NET grade 2, 1.22% neuroendocrine cell hyperplasia, 1,22% fundic gland polyps, 1.22% hamarmatous polyp, 1.22% reactive gastropathy, 1.22% lipomas, 1.22% squamous papillomas and 1.22% pyloric gland hyperplasia. Of the total lesions, 12.2% were pediculated, and 87.8% were sessile. En-bloc resection was performed in 80 (97.5%) lesions, and complete excision in 79 (96.3%). Surgery was performed in two cases due to invasive carcinoma. No complications were observed.

Conclusion

EMR can be safely performed in benign, premalignant and malignant mucosal lesions <2 cm with high success rates of en-bloc and complete excision and low risk of complications.