• Saeed Ali, Neelam Khetpal, Evgeny Idrisov, Asad Ur Rahman, Sameen Khalid, Yuan Du, Udayakumar Navaneethan, Shyam Varadarajulu, Robert Hawes, and Muhammad Khalid Hasan.
• From the Department of Internal Medicine, University of Iowa Health Care, Iowa City, the Department of Internal Medicine, Hartford Healthcare, Hartford, Connecticut, the Division of Gastroenterology and Hepatology, University of Oklahoma Health Sciences Center, Oklahoma City, the Division of Gastroenterology and Hepatology, Cleveland Clinic Florida, Weston, the Division of Gastroenterology and Hepatology, University of New Mexico, Albuquerque, AdventHealth Research Institute and the Center for Interventional Endoscopy, AdventHealth Orlando, Orlando, Florida.
• South. Med. J. 2021 Apr 1; 114 (4): 199-206.

ObjectivesEndoscopic mucosal resection (EMR) is an alternative to surgery for the treatment of large laterally spreading lesions. Residual or recurrent adenoma is a major limitation. This study aimed to quantify early and late recurrences and to assess its associated risk factors.MethodsThe study was a single-center, multiendoscopist, longitudinal study conducted between January 1, 2013 and April 26, 2017. A total of 480 patients with 500 polyps who underwent an endoscopic resection were included. Surveillance colonoscopy (SC) was performed at 4 to 6 months (SC1) and 16 to 18 months (SC2).ResultsAt SC1, early recurrence was noted in 77 of 354 (21.8%) lesions; 76 (98.7%) were treated endoscopically. The remaining 277 of 354 (78.2%) lesions had no recurrence at SC1; only 41 lesions (15%) were followed up at SC2. Recurrence at SC2 was found in 4 lesions (9.8%), all of which were treated endoscopically. Lesion size >40 mm was associated with recurrence. Recurrence at both SC1 and SC2 was successfully treated endoscopically in 78 of 81 lesions (96.3%).ConclusionsEMR is an effective, minimally invasive technique for the treatment of large laterally spreading lesions. Although recurrence is a concern, its risk is low (21.8% on SC1 and 9.8% on SC2) and was managed endoscopically in 96.3% cases on follow-up endoscopy.

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