Colonic Polyps Clinical Trial
Official title:
Comparison Between EMR and Precut-EMR for Colorectal Polyp; Randomized Prospective Study
This study was attempted to determine the efficacy and complication of precut EMR comparing with convetional EMR for resecting of 10 ~ 20 mm colon polyp through prospective, randomized controlled trial.
In general, a potential risk of advanced colorectal neoplasia is proportional with size.
However, recent study report that occurence rate of advanced neoplasia in small polyp is 9 ~
10 %. And, incidence of interval cancer after screening colonoscopy was reported as 10 ~ 27%.
So We can suspect that complete resection of small polyp is important. Previous study
recommended that endoscopic submucosal dissection (ESD) is a safe and effective procedure for
treating colon polyp larger than 20 mm because of high complete resection rate and low
recurrence rate. In contrast, endoscopic mucosal resection (EMR) is more recommended for
resecting colon polyp smaller than 20 mm because of technical ease and low rate of
complication.
However, Complete resection rate of conventional EMR is 60 ~ 70%. In case of incomplete
resection, local recurrence rate is higher than complete resection. And In case of
adenocarcinoma, specimen of piecemeal resection cannot be evaluated a depth of invasion and
resection margin, and physician cannot decide a therapeutic plan.
In precut-EMR, mucosal resection is performed after pre-incision around a polyp. When precut
EMR of polyp > 20 mm was performed in previous study, complete resection rate and en-bloc
resection rate were higher and local recurrence rate was lower than conventional EMR. But,
there is no study of comparsion precut EMR and conventional EMR for resecting colon polyp <
20 mm. This study was attempted to determine the efficacy and complication of precut EMR
comparing with convetional EMR through prospective, randomized controlled trial.
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