The influence of clips on the post-endoscopic mucosal resection scar: clip artifact (original) (raw)

Gastrointestinal endoscopy, 2015

Abstract

Laterally spreading lesions ≥20 mm (LSL) are conventionally removed by endoscopic mucosal resection (EMR). Endoscopic clips are increasingly used to mitigate the risk of delayed bleeding. Clips may alter the endoscopic appearance of the post-EMR scar, interfering with the assessment of adenoma recurrence. We aimed to evaluate this. Prospective, single-center data from the Australian Colonic Endoscopic resection study (ACE) was analyzed (January 2011 to May 2015). Patients undergoing EMR of LSL with endoscopic clips used at the EMR defect were eligible. Data included patient and lesion characteristics and procedural, clinical, and histologic outcomes. Clips were used in 111 of 885 (12.5%) lesions. 62 of 111 clipped lesions had standardized high-definition white light and narrow-band images of the post-EMR scar at first surveillance colonoscopy and were enrolled. Analysis of the images showed 4 situations: a bland scar (N = 27), residual adenoma (N = 6), mucosal elevation with normal ...

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