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Validation of treatment algorithm based on the Japan narrow-band imaging expert team classification for sub-centimeter colorectal polyps

BACKGROUND AND STUDY AIMS:  Although cold polypectomy (CP) is widely used for colorectal polyps < 10 mm, appropriateness of indications for CP or endoscopic mucosal resection (EMR) are still unclear. The aim of this study was to validate the endoscopic treatment algorithm based on the Japan NBI E...

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Autores principales: Kato, Motohiko, Abe, Keiichiro, Kubosawa, Yoko, Sunata, Yukie, Hirai, Yuichiro, Hirata, Tetsu, Takada, Yoshiaki, Wada, Michiko, Takatori, Yusaku, Banno, Shigeo, Kinoshita, Satoshi, Mori, Hideki, Takabayashi, Kaoru, Kikuchi, Masahiro, Shiraishi, Junichi, Uraoka, Toshio
Formato: Online Artículo Texto
Lenguaje:English
Publicado: © Georg Thieme Verlag KG 2018
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6070374/
https://www.ncbi.nlm.nih.gov/pubmed/30083581
http://dx.doi.org/10.1055/a-0621-4445
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author Kato, Motohiko
Abe, Keiichiro
Kubosawa, Yoko
Sunata, Yukie
Hirai, Yuichiro
Hirata, Tetsu
Takada, Yoshiaki
Wada, Michiko
Takatori, Yusaku
Banno, Shigeo
Kinoshita, Satoshi
Mori, Hideki
Takabayashi, Kaoru
Kikuchi, Masahiro
Shiraishi, Junichi
Uraoka, Toshio
author_facet Kato, Motohiko
Abe, Keiichiro
Kubosawa, Yoko
Sunata, Yukie
Hirai, Yuichiro
Hirata, Tetsu
Takada, Yoshiaki
Wada, Michiko
Takatori, Yusaku
Banno, Shigeo
Kinoshita, Satoshi
Mori, Hideki
Takabayashi, Kaoru
Kikuchi, Masahiro
Shiraishi, Junichi
Uraoka, Toshio
author_sort Kato, Motohiko
collection PubMed
description BACKGROUND AND STUDY AIMS:  Although cold polypectomy (CP) is widely used for colorectal polyps < 10 mm, appropriateness of indications for CP or endoscopic mucosal resection (EMR) are still unclear. The aim of this study was to validate the endoscopic treatment algorithm based on the Japan NBI Expert Team (JNET) classification. PATIENTS AND METHODS:  Consecutive patients with at least one colorectal non-pedunculated polyp < 10 mm between July 2014 and October 2016 were included in this retrospective study. During the period, EMR was performed for JNET ≥ 2B lesions and CP for JNET < 2A. Among a total of 3966 lesions, 3368 lesions with JNET ≤ 2A were resected by CP in compliance with the treatment algorithm but 565 resections for JNET ≤ 2A were not compliant (by EMR), while all 24 JNET > 2B lesions were removed by EMR in compliance with the algorithm. Polypectomy outcomes were compared between the compliant and non-compliant groups. Histological outcomes were analyzed in accordance with JNET classification. RESULTS:  Post-polypectomy bleeding rate in the compliant group (0 %) was lower than that in the non-compliant group (0.53 %, P  < 0.01). Proportion of lesions diagnosed as cancer (38 % vs 0.36 %, P  < 0.01) or submucosal cancer (4.2 % vs 0.03 %, P  = 0.012), and the lesion with free resection margin (91 % vs 64 %, P  < 0.01) was higher in the JNET ≥ 2B than JNET ≤ 2A. CONCLUSION:  This study indicated our algorithm would be valid: CP is suitable for most polyps < 10 mm as incidence of post-polypectomy bleeding is low, whereas EMR is recommended for JNET ≥ 2B lesions for histological complete removal.
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spelling pubmed-60703742018-08-06 Validation of treatment algorithm based on the Japan narrow-band imaging expert team classification for sub-centimeter colorectal polyps Kato, Motohiko Abe, Keiichiro Kubosawa, Yoko Sunata, Yukie Hirai, Yuichiro Hirata, Tetsu Takada, Yoshiaki Wada, Michiko Takatori, Yusaku Banno, Shigeo Kinoshita, Satoshi Mori, Hideki Takabayashi, Kaoru Kikuchi, Masahiro Shiraishi, Junichi Uraoka, Toshio Endosc Int Open BACKGROUND AND STUDY AIMS:  Although cold polypectomy (CP) is widely used for colorectal polyps < 10 mm, appropriateness of indications for CP or endoscopic mucosal resection (EMR) are still unclear. The aim of this study was to validate the endoscopic treatment algorithm based on the Japan NBI Expert Team (JNET) classification. PATIENTS AND METHODS:  Consecutive patients with at least one colorectal non-pedunculated polyp < 10 mm between July 2014 and October 2016 were included in this retrospective study. During the period, EMR was performed for JNET ≥ 2B lesions and CP for JNET < 2A. Among a total of 3966 lesions, 3368 lesions with JNET ≤ 2A were resected by CP in compliance with the treatment algorithm but 565 resections for JNET ≤ 2A were not compliant (by EMR), while all 24 JNET > 2B lesions were removed by EMR in compliance with the algorithm. Polypectomy outcomes were compared between the compliant and non-compliant groups. Histological outcomes were analyzed in accordance with JNET classification. RESULTS:  Post-polypectomy bleeding rate in the compliant group (0 %) was lower than that in the non-compliant group (0.53 %, P  < 0.01). Proportion of lesions diagnosed as cancer (38 % vs 0.36 %, P  < 0.01) or submucosal cancer (4.2 % vs 0.03 %, P  = 0.012), and the lesion with free resection margin (91 % vs 64 %, P  < 0.01) was higher in the JNET ≥ 2B than JNET ≤ 2A. CONCLUSION:  This study indicated our algorithm would be valid: CP is suitable for most polyps < 10 mm as incidence of post-polypectomy bleeding is low, whereas EMR is recommended for JNET ≥ 2B lesions for histological complete removal. © Georg Thieme Verlag KG 2018-08 2018-08-01 /pmc/articles/PMC6070374/ /pubmed/30083581 http://dx.doi.org/10.1055/a-0621-4445 Text en https://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License, which permits unrestricted reproduction and distribution, for non-commercial purposes only; and use and reproduction, but not distribution, of adapted material for non-commercial purposes only, provided the original work is properly cited.
spellingShingle Kato, Motohiko
Abe, Keiichiro
Kubosawa, Yoko
Sunata, Yukie
Hirai, Yuichiro
Hirata, Tetsu
Takada, Yoshiaki
Wada, Michiko
Takatori, Yusaku
Banno, Shigeo
Kinoshita, Satoshi
Mori, Hideki
Takabayashi, Kaoru
Kikuchi, Masahiro
Shiraishi, Junichi
Uraoka, Toshio
Validation of treatment algorithm based on the Japan narrow-band imaging expert team classification for sub-centimeter colorectal polyps
title Validation of treatment algorithm based on the Japan narrow-band imaging expert team classification for sub-centimeter colorectal polyps
title_full Validation of treatment algorithm based on the Japan narrow-band imaging expert team classification for sub-centimeter colorectal polyps
title_fullStr Validation of treatment algorithm based on the Japan narrow-band imaging expert team classification for sub-centimeter colorectal polyps
title_full_unstemmed Validation of treatment algorithm based on the Japan narrow-band imaging expert team classification for sub-centimeter colorectal polyps
title_short Validation of treatment algorithm based on the Japan narrow-band imaging expert team classification for sub-centimeter colorectal polyps
title_sort validation of treatment algorithm based on the japan narrow-band imaging expert team classification for sub-centimeter colorectal polyps
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6070374/
https://www.ncbi.nlm.nih.gov/pubmed/30083581
http://dx.doi.org/10.1055/a-0621-4445
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