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| 1 | Multicenter evaluation of recurrence in endoscopic submucosal dissection and endoscopic mucosal resection in the colon:A Western perspective显示文摘BACKGROUND While colon endoscopic mucosal resection(EMR)is an effective technique,removal of larger polyps often requires piecemeal resection,which can increase recurrence rates.Endoscopic submucosal dissection(ESD)in the colon offers the ability for en bloc resection and is well-described in Asia,but there are limited studies comparing ESD vs EMR in the West.AIM To evaluate different techniques in endoscopic resection of large polyps in the colon and to identify factors for recurrence.METHODS The study is a retrospective comparison of ESD,EMR and knife-assisted endoscopic resection performed at Stanford University Medical Center and Veterans Affairs Palo Alto Health Care System between 2016 and 2020.Knife-assisted endoscopic resection was defined as use of electrosurgical knife to facilitate snare resection,such as for circumferential incision.Patients≥18 years of age undergoing colonoscopy with removal of polyp(s)≥20 mm were included.The primary outcome was recurrence on follow-up.RESULTS A total of 376 patients and 428 polyps were included.Mean polyp size was greatest in the ESD group(35.8 mm),followed by knife-assisted endoscopic resection(33.3 mm)and EMR(30.5 mm)(P<0.001).ESD achieved highest en bloc resection(90.4%)followed by knife-assisted endoscopic resection(31.1%)and EMR(20.2%)(P<0.001).A total of 287 polyps had follow-up(67.1%).On follow-up analysis,recurrence rate was lowest in knife-assisted endoscopic resection(0.0%)and ESD(1.3%)and highest in EMR(12.9%)(P=0.0017).En bloc polyp resection had significantly lower rate of recurrence(1.9%)compared to non-en bloc(12.0%,P=0.003).On multivariate analysis,ESD(in comparison to EMR)adjusted for polyp size was found to significantly reduce risk of recurrence[adjusted hazard ratio 0.06(95%CI:0.01-0.57,P=0.014)].CONCLUSION In our study,EMR had significantly higher recurrence compared to ESD and knife-assisted endoscopic resection.We found factors including resection by ESD,en bloc removal,and use of circumferential incision were associated with significantly decreased recurrence.While further studies are needed,we have demonstrated the efficacy of ESD in a Western population. | Mike T Wei Margaret J Zhou Andrew A Li Andrew Ofosu Joo Ha Hwang Shai Friedland | 2023 | World Journal of Gastrointestinal Endoscopy2023，15，6： | 2 |
| 2 | Training Induced Alteration of Glucose Flux in Men显示文摘 | FRIEDLANDER ANNE L GRETCHEN A | 1997 | J Appl Physiol1997，82，4： | 1 |
| 3 | Direction finding using spatial smoothing with interpolated arrays 显示文摘 | FRIEDLANDER B WEISS A J | 1993 | IEEE Transaction on Signal Processing1993，41，4： | 1 |
| 4 | Eigenstructure methods for direction finding with sensor gain and phase uncertainties 显示文摘 | Weiss A J Friedlander B | 1990 | Circutis Systems Signal Process1990，9，3： | 1 |
| 5 | Meta - analysis of randomized controlled trials of intracoronary versus intravenous adminis- tration of glycoprotein Ilb/IIIa inhibitors during percutaneous coronary intervention for acute coronary syndrome 显示文摘 | Friedland S Eisenberg M J Shimony A | 2011 | Am J Cardiol2011，108，9： | 1 |
| 6 | Oversampled Gabor representation for transient signals显示文摘 | Friedlander B Zriela A | 1995 | IEEE Transactions on Signal Processing1995，43，9： | 1 |
| 7 | EAP actions and options显示文摘 | Masi D A Friedland S J | 1988 | Personnel Journal1988，67，6： | 1 |
| 8 | Eigenstructure methods for direction finding with sensor gain and phase uncertainties显示文摘 | WEISS A J FRIEDLANDER B | 1990 | Circuits Syst Signal Processing1990，9，2： | 1 |
| 9 | Genetic and environmental risk factors for Alzheimer's disease in Israeli Arabs显示文摘 | Bowirrat A Friedland R P Farrer L | 2002 | J Mol Neurosci2002，19，12： | 1 |
| 10 | Insitu expression of angiopoietins in astrocytomas identifies angiopoietin-2 as an early marker of tumor angiogenesis显示文摘 | Zagazag D Hooper A Friedlander DR | 1999 | Clin Cancer Res1999，5，9： | 1 |
| 11 | In situ expression of angiopoietins in astrocytomas identifies anagiopoietin-2 as an early marker of tumour angiogenesis显示文摘 | ZAGZAG D HOOPER A FRIEDLANDER D R | 1999 | Exp Neurol1999，159，： | 1 |
| 12 | Eigenstructure methods for direc- tion finding with sensor gain and phase uncertainties显示文摘 | Weiss A J Friedlander B | 1993 | Cir- cuits Syst Signal Processing1993，12，1： | 1 |
| 13 | Direction finding in the presence of mutual coupling显示文摘 | Friedlander B Weiss A J | 1991 | IEEE Trans on AP1991，39，3： | 1 |
| 14 | Effects of modeling errors on the resolution threshold of the MUSIC algorithm 显示文摘 | WEISS A J Friedlander B | 1994 | IEEE Transactions on Signal Processing1994，42，6： | 1 |
| 15 | Effect of Exercise Intensity and Training on Lipid Metabolism in Yong Women显示文摘 | FRIEDLANDER ANNE L GRETCHEN A | 1998 | Am J Physiol1998，275，38： | 1 |
| 16 | Direction Finding Using Spatial Smoothing with Interpolated Array显示文摘 | Friedlander B Weiss A J | 1992 | IEEE Transactions on Aerospace and Electronic Systems1992，28，2： | 1 |
| 17 | Direction finding in the presence of mutual coupling显示文摘 | FRIEDLANDER B WEISS A J | 1991 | IEEE Transactions on Antennas and Propagation1991，39，3： | 1 |
| 18 | Range and bearing estimation using polynomial rooting显示文摘 | Weiss A J Friedlander B | 1993 | IEEE J Ocean Engr1993，18，2： | 1 |
| 19 | Bilateral sudden sensorineural hearing loss:review显示文摘 | SARA S A TEH B M FRIEDLAND P | 2014 | J Laryngol Otol2014，128，： | 1 |
| 20 | Market structureand multiproduct industries显示文摘 | BAILEY E E FRIEDLANDER A F | 1982 | Journal of Economic Literature1982，，3： | 1 |
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