Endoscopic Resection of Cecal Polyps Involving the Appendiceal Orifice: A KASID Multicenter Study

Eun Mi Song, Hyo Joon Yang, Hyun Jung Lee, Hyun Seok Lee, Jae Myung Cha, Hyun Gun Kim, Yunho Jung, Chang Mo Moon, Byung Chang Kim, Jeong Sik Byeon

Research output: Contribution to journalArticlepeer-review

16 Scopus citations

Abstract

Background: Endoscopic resection of polyps located at the appendiceal orifice (AO) is challenging, and the feasibility and outcomes of endoscopic resection for cecal polyps involving AO are unconfirmed. Aims: We evaluated the feasibility and outcomes of endoscopic resection for cecal polyps involving AO. Methods: In this retrospective, multicenter study involving nine tertiary referral centers, we evaluated 131 patients who underwent endoscopic resection for cecal polyps involving AO. Results: The median size of polyps resected was 10 mm (range 3–60 mm). Endoscopic mucosal resection, endoscopic piecemeal mucosal resection, and endoscopic submucosal dissection were performed in 75 (57.3%), 31 (23.7%), and 5 (3.8%) patients, respectively. The en bloc resection rate was 68.7%. Endoscopic complete resection was achieved in 123 lesions (93.9%). Intraprocedural and delayed bleeding occurred in 14 (10.7%) and three patients (2.3%), respectively, and perforation occurred in two patients (1.5%). Seven patients (5.3%) underwent additional surgery because of treatment failure or recurrence. Polyps of ≥20 mm in size showed significantly higher rates of perforation and additional surgery (p < 0.05), and a lower rate of en bloc resection (p < 0.005). Patients with polyps involving ≥75% of AO circumference exhibited a significantly lower rate of en bloc resection (p < 0.001), and significantly higher rates of surgery and recurrence (p < 0.05). Recurrence during follow-up occurred in 12 patients (15.6%); polyps involving ≥75% of AO circumference were an independent risk factor for recurrence. Conclusion: Endoscopic resection of cecal polyps involving AO is safe and effective in select patients.

Original languageEnglish
Pages (from-to)3138-3148
Number of pages11
JournalDigestive Diseases and Sciences
Volume62
Issue number11
DOIs
StatePublished - 1 Nov 2017

Keywords

  • Appendix
  • Colonic polyps
  • Colonoscopy
  • Endoscopic mucosal resection
  • Endoscopic submucosal dissection

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