April 13, 2016
Colon polyp surgery not always necessary
BY Laura Sussman
Using the latest advances in endoscopic resection techniques, more than 75 percent of patients with complex colon polyps could avoid surgery for their polyp removal, according to new research from MD Anderson Cancer Center.
The findings, published in Gastrointestinal Endoscopy, show that endoscopic mucosal resection (EMR) is safe and effective for those with complex polyps and could allow more patients to avoid surgery and its associated risks and costs.
Complex colon polyps are large or often flat lesions thought too difficult to remove endoscopically based on size or location. Patients therefore are often referred for surgical polyp removal. Fears of adverse events, high recurrence rates after piecemeal resection, and the potential for medical or legal risk associated with cancers after incomplete resection also contribute to surgical referrals.
During the last decade, improvements in resection procedures and technology to manage bleeding and perforation have allowed specialized, trained endoscopists to remove complex polyps with gastrointestinal EMR. However, the procedure requires specialized training which is not always accessible in the general medical community, said Gottumukkala S. Raju, M.D., professor, Gastroenterology, Hepatology & Nutrition.
The EMR procedure is a delicate colonoscopy technique performed with an endoscope to remove polyps, while avoiding the need to make surgical incisions in the abdominal wall. Lesions are first lifted from the colon by carefully injecting fluid into the colon wall underneath the lesion. They are then carefully shaved off, along with superficial layers of colon, without damaging deeper layers.
“Complete resections of these complex colon polyps are technically challenging, yet are too often referred to surgery. Surgery comes with substantial risk and cost to the patient. Our research shows that this is not medically necessary. With proper training, the majority of patients could be treated with an endoscopic mucosal resection,” said Raju, the study’s corresponding author.
Learn more about this study in the MD Anderson Newsroom, and watch Raju discuss the study below: