Efficacy and safety of cap-assisted endoscopic mucosal resection for treatment of nonlifting colorectal polyps

Abstract

Background Suboptimal lifting increases complexity of endoscopic mucosal resection (EMR) for benign colorectal polyps. Cap-assisted EMR (EMR-C) may allow fibrotic polyp tissue to be captured in the snare. This study evaluated the efficacy and safety of EMR-C for benign nonlifting colorectal polyps. Methods This was a multicenter study, which prospectively registered all EMR-C procedures (2016 2018) for presumed benign nonlifting colorectal polyps. Results 70 nonlifting polyps with a median size of 25mm (interquartile range [IQR] 15 40) were treated with EMRC. Complete polyp removal was achieved in 68 (97.1%), including 47 (67.1 %) with EMR-C alone. Overall, 66 polyps showed benign histology, and endoscopic follow-up after a median of 6 months (IQR 6 10) showed recurrence in 19.7%. First (n = 10) and second (n = 2) benign recurrences were all treated endoscopically. Deep mural injury type III V occurred in 7.4% and was treated successfully with clips. Conclusion EMR-C may be an alternative therapeutic option for removal of benign nonlifting polyp tissue. Although recurrence still occurs, repeat endoscopic therapy usually leads to complete polyp clearance.