Skip to main content


Log in

Endoscopic mucosal resection for colorectal neoplastic lesions

  • Original Contributions
  • Published:
Diseases of the Colon & Rectum


PURPOSE: Endoscopic mucosal resection, which is a new option for endoscopic polypectomy of colorectal polyps without stalks, was evaluated on its usefulness in polypectomy. METHODS: Three hundred thirty-seven lesions, which were removed by endoscopic mucosal resection between January 1990 and January 1993, were studied. The endoscopic configuration of neoplastic lesions were classified into four types: flat, sessile, large sessile with distinct lobulations, and semipedunculated. RESULTS: The 337 lesions included 243 adenomas, 30 mucosal cancers, 13 submucosal cancers, 3 carcinoids, 43 hyperplastic polyps, and 5 inflammatory polyps. Of the 286 neoplastic lesions, excluding 3 carcinoids, 137 were flat, 81 were sessile, 18 were large sessile, and 50 were semipedunculated. The 137 flat lesions consisted of 125 adenomas, 10 mucosal cancers, and 2 submucosal cancers. The rate of complete removal was related to their size and configuration and was 87 percent in flat neoplastic lesions. Lesion diameters of greater than 20 mm and the large sessile-type configurations were factors that were associated with incomplete removal. Two (0.7 percent) cases were complicated by perforations, and one (0.4 percent) case was complicated by bleeding. CONCLUSION: Endoscopic mucosal resection is an useful option for complete removal of colorectal nonpolypoid adenomas and cancers.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others


  1. Davis GR, Santa Ana CA, Morawski SG, Fordtran JS. Development of a lavage solution associated with minimal water and electrolyte absorption of secretion. Gastroenterology 1980;78:991–5.

    PubMed  CAS  Google Scholar 

  2. Muto T, Kamiya J, Sawada T,et al. Small “flat adenoma” of the large bowel with special reference to its clinicopathologic features. Dis Colon Rectum 1985;28:847–51.

    PubMed  CAS  Google Scholar 

  3. Lynch HT, Smyrk T, Lanspa ST,et al. Flat adenomas in a colon cancer-prone kindred. J. Natl Cancer Inst 1988;80:278–82.

    PubMed  CAS  Google Scholar 

  4. Kuramoto S, Oohara T. Flat early cancer of the large intestine. Cancer 1989;64:950–5.

    PubMed  CAS  Google Scholar 

  5. Kudo S, Miura K, Takano Y,et al. Detection of colorectal cancer. Stomach and Intestine 1990;25:801–2.

    Google Scholar 

  6. Adachi M, Ryan P, Collopy B,et al. Adenomacarcinoma sequence of the large bowel. Aust N Z J Surg 1991;61:409–14.

    PubMed  CAS  Google Scholar 

  7. Ishii H, Tatsuta M, Tsutsui S,et al. Early depressed adenocarcinoma of the large intestine. Cancer 1992;69:2406–10.

    PubMed  Google Scholar 

  8. Lanspa SJ, Rouse J, Smyrk T, Watson P, Jenkins JX, Lynch HT. Epidemiologic characteristics of the flat adenoma of Muto: a prospective study. Dis Colon Rectum 1992;35:543–6.

    Article  PubMed  CAS  Google Scholar 

  9. Deyhle P, Largiader F, Jenny S, Fumagalli I. A method for endoscopic electroresection of sessile colonic polyps. Endoscopy 1973;5:38–40.

    Article  Google Scholar 

  10. Yao T, Takenaka K, Sakurai T, Matsui T. Initial endoscopic examination as a screening procedure of early gastric cancer. Stomach and Intestine 1993;28:45–55.

    Google Scholar 

  11. Nishimata H, Niiyama I, Ooi H,et al. Screening test for early gastric cancer, advantage and disadvantage of routine upper GI X-ray examination. Stomach and Intestine 1993;28:33–43.

    Google Scholar 

  12. Tada M, Shimada M, Yanai H,et al. Development of a new method of endoscopic biopsy “strip-biopsy.” Stomach and Intestine 1984;19:1109–16.

    Google Scholar 

  13. Sugihara K, Muto T. Flat adenoma: a new concept in the pathogenesis of colorectal cancer. J Clin Gastroenterol 1994 (in press).

  14. Adachi M, Muto T, Okinaga K, Morioka Y. Clinicopathologic features of the flat adenoma. Dis Colon Rectum 1991;34:981–6.

    Article  PubMed  CAS  Google Scholar 

  15. Wolber RA, Owen DA. Flat adenoma of the colon. Hum Pathol 1991;34:981–6.

    Google Scholar 

  16. Muto T, Masaki T, Suzuki K. DNA ploidy pattern of flat adenomas of the large bowel. Dis Colon Rectum 1991;34:696–8.

    PubMed  CAS  Google Scholar 

  17. Karita M, Tada M, Okita K, Kodama T. Endoscopic therapy for early colon cancer: the strip biopsy resection technique. Gastrointest Endosc 1991;37:128–32.

    PubMed  CAS  Google Scholar 

  18. Walsh RM, Ackroyd FW, Shellito PC. Endoscopic resection of large sessile colorectal polyps. Gastrointest Endosc 1992;38:303–9.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations


About this article

Cite this article

Yokota, T., Sugihara, K. & Yoshida, S. Endoscopic mucosal resection for colorectal neoplastic lesions. Dis Colon Rectum 37, 1108–1111 (1994).

Download citation

  • Issue Date:

  • DOI:

Key words