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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 | Porcine parvovirus DNA:charaeterization of the genomie and replieation form DNA of two viruses isolates显示文摘 | Molitor T W Joo H S Collett M S | 1984 | Virology1984，137，2： | 1 |
| 3 | Role of luteal glucocorticoid metabolism during maternal recognition of pregnancy in women显示文摘 | MicheUe M Nirmala M K Joo T | 2007 | Endocrinology2007，148，12： | 1 |
| 4 | The relationship of sarcoplasmic and myofibrillar protein solubility to colour and water- holding capacity in porcine longissimus muscle显示文摘 | JOO S T KAUFFMAN R G KIM B C | 1999 | Meat Science1999，52，3： | 1 |
| 5 | Large - scale nonhydrolytic sol- gel synthesis of uniform- sized ceria nanocrystals with spherical, wWire, and tadpole shapes 显示文摘 | Yu T Joo J Park Y I | 2005 | Ange- wandte Chemie2005，117，45： | 1 |
| 6 | Identification and characterization of a porcine parvovirus nonstructural polypeptide 显示文摘 | Molitor T W Joo H S Collett M S | 1985 | J Virol1985，55，3： | 1 |
| 7 | Prevalence of regulatory T cells is increased in peripheral blood and tumor microenvironment of patients with pancreas or breast adenocarcinoma显示文摘 | Liyanage U K Moore T T Joo H G | 2002 | J Immunol2002，169，： | 1 |
| 8 | Development of thermo- stable Candidaantarctica lipase B through novel in silico design of disulfidebridge显示文摘 | LE Q A T JOO J C YOO Y J | 2012 | Biotechnology and Bioengineering2012，109，4： | 1 |
| 9 | Effects of dietary conjugated linoleic acid on fatty acid composition,lipid ozfidation,color,and water-holding capacity of pork loin显示文摘 | Joo S T Lee J l Ha Y L | 2002 | J Anita Sci2002，80，1： | 1 |
| 10 | Vascular basis of mucosal color显示文摘 | Kleirtheinz J Buchter A Fillies T Joos U | 2005 | Head Face Med2005，1，： | 1 |
| 11 | Multi-object identification for mobile robot using ultrasonic sensors显示文摘 | Zhong SLim Soon T Kwon Moon G Joo | 2012 | International Journal of Control Automation and Systems2012，10，3： | 1 |
| 12 | Porcine Parvovirus:Virus purification and Structural and Antigentic properties of Virion Polypeptides显示文摘 | Molitor T Joo H Collett M | 1983 | J Virol1983，45，： | 1 |
| 13 | A feasibility study using interactive commercial off-the-shelf computer gaming in upper limb rehabilitation in patients after stroke 显示文摘 | Yong Joo L Soon Yin T Xu D | 2010 | J Rehabil Med2010，42，5： | 1 |
| 14 | Accounting choice and future performance: the case of R&D accounting in France 显示文摘 | CAZAVAN -JENY A JEANJEAN T JOOS P | 2011 | Journal of Accounting and Public Policy2011，30，2： | 1 |
| 15 | Inhibition of Porcine Parvovirus Replication by Empty Virus Particles显示文摘 | Molitor T W Joo H S | 1987 | Arch Virol1987，96，12： | 1 |
| 16 | The thermal effects on electrospinning of polylactic acid mehs 显示文摘 | ZHOU H GREEN T B JOO Y L | 2006 | Polymer2006，47，21： | 1 |
| 17 | Prevalence of regulatory T cells is increased in peripheral blood and tumor microenvironment of patients with pancreas or breast adenocarcinoma 显示文摘 | Liyanade U K Moore T T Joo H G | 2002 | J Immunol2002，169，5： | 1 |
| 18 | Conducting polymer nanotube and nanow ire synthesized by using nanoporous template:synthesis,characteristics,and ap plications 显示文摘 | Joo J Park K T Kim M S | 2003 | Synthetic Metals2003，1351，1： | 1 |
| 19 | Porcine parvovirus:virus purification and structural and antigenic properties ofvirion polypeptides显示文摘 | MOLITOR T H JOO H S COLLETT M S | 1983 | J Viml1983，45，： | 1 |
| 20 | Effects of dietary conjugated linoleic acid on fatty acid composition,lipid oxidation,color, and water-holding capacity of pork loin 显示文摘 | JOO S T LEE J I HA Y L | 2002 | J Anita Sci2002，80，： | 1 |
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