Our Summary

This research paper is about the best way to remove certain types of growths (called sessile colorectal polyps) from the colon. Colorectal polyps are often precursors to colon cancer, so it’s important to remove them completely. The most common methods, such as endoscopic mucosal resection (EMR) and snare polypectomy, sometimes fail to remove the entire polyp, which can lead to cancer down the line.

The study examines a newer technique called EMR with circumferential precutting (EMR-P). This method involves injecting a substance under the polyp to lift it away from the colon wall, then using a small snare to cut around the polyp before removing it.

Seven medical institutions in China were involved in this study. They randomly assigned patients with polyps of a certain size (10-20 mm) to either the EMR-P group or the conventional EMR group.

The results showed that EMR-P was more effective at completely removing the polyps in one piece, particularly for larger polyps (>15mm). However, the EMR-P technique took longer to perform. There was no significant difference in adverse events (things like complications or side effects) between the two groups.

In conclusion, the study suggests that EMR-P could be a better option for removing larger colon polyps, but it does take a bit longer.

FAQs

  1. What is EMR with circumferential precutting (EMR-P) and how does it differ from traditional EMR?
  2. What were the results of the study comparing EMR-P to conventional EMR for removing colorectal polyps?
  3. Are there any additional risks or complications associated with EMR-P compared to conventional EMR methods?

Doctor’s Tip

A doctor might tell a patient undergoing intestinal resection that using newer techniques like EMR with circumferential precutting (EMR-P) may be more effective in completely removing polyps, particularly larger ones. However, they should be prepared for a longer procedure time. It’s important to discuss these options with your doctor to determine the best treatment plan for you.

Suitable For

Patients who are typically recommended for intestinal resection include those with large sessile colorectal polyps, particularly those larger than 15mm in size. These patients may be at a higher risk for developing colon cancer if the polyps are not completely removed. Additionally, patients who have had previous unsuccessful attempts at polyp removal using conventional methods such as EMR or snare polypectomy may also be recommended for intestinal resection using the EMR-P technique. Overall, patients who require a more effective method for removing large colon polyps that have a higher risk of becoming cancerous may benefit from intestinal resection using the EMR-P technique.

Timeline

Before the intestinal resection procedure, the patient would likely have undergone various tests and imaging studies to diagnose the colorectal polyps. They may have also received counseling and information about the procedure, as well as instructions on how to prepare for it, such as fasting and taking certain medications.

During the intestinal resection procedure, the patient would be placed under anesthesia and the surgeon would use a laparoscopic or open surgical approach to remove the affected portion of the intestine. The surgery may take several hours, depending on the complexity of the case.

After the intestinal resection, the patient would typically stay in the hospital for a few days to recover. They would be closely monitored for any complications, such as infection or bleeding. The patient would also receive pain medication and be advised on how to care for the surgical incision.

In the weeks following the intestinal resection, the patient would gradually resume normal activities and follow-up appointments with their healthcare provider would be scheduled to monitor their recovery and ensure that the surgery was successful in removing the colorectal polyps.

What to Ask Your Doctor

  1. What is the success rate of EMR-P compared to traditional methods in completely removing colorectal polyps?
  2. What are the potential risks or complications associated with EMR-P?
  3. How long does the EMR-P procedure typically take to perform?
  4. Are there any specific criteria or characteristics that make a patient a better candidate for EMR-P?
  5. How soon after the procedure can I expect to receive results or follow-up care?
  6. Will I need any additional monitoring or surveillance after undergoing EMR-P?
  7. Are there any dietary or lifestyle changes I should make following the procedure to promote healing and prevent complications?
  8. Will I experience any discomfort or side effects during the recovery period after EMR-P?
  9. How often should I undergo follow-up screenings to monitor for any potential recurrence of colorectal polyps?
  10. Are there any alternative treatments or procedures that should be considered in conjunction with or instead of EMR-P for colorectal polyp removal?

Reference

Authors: Zhang XQ, Sang JZ, Xu L, Mao XL, Li B, Zhu WL, Yang XY, Yu CH. Journal: World J Gastroenterol. 2022 Dec 7;28(45):6397-6409. doi: 10.3748/wjg.v28.i45.6397. PMID: 36533110