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

Motohiko Kato; Keiichiro Abe; Yoko Kubosawa; Yukie Sunata; Yuichiro Hirai; Tetsu Hirata; Yoshiaki Takada; Michiko Wada; Yusaku Takatori; Shigeo Banno; Satoshi Kinoshita; Hideki Mori; Kaoru Takabayashi; Masahiro Kikuchi; Junichi Shiraishi; Toshio Uraoka

doi:10.1055/a-0621-4445

Endoscopy International Open (Aug 2018)

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

Motohiko Kato,
Keiichiro Abe,
Yoko Kubosawa,
Yukie Sunata,
Yuichiro Hirai,
Tetsu Hirata,
Yoshiaki Takada,
Michiko Wada,
Yusaku Takatori,
Shigeo Banno,
Satoshi Kinoshita,
Hideki Mori,
Kaoru Takabayashi,
Masahiro Kikuchi,
Junichi Shiraishi,
Toshio Uraoka

Affiliations

Motohiko Kato: Department of Gastroenterology, National Hospital Organization Tokyo Medical Center, Tokyo, Japan
Keiichiro Abe: Department of Gastroenterology, National Hospital Organization Tokyo Medical Center, Tokyo, Japan
Yoko Kubosawa: Department of Gastroenterology, National Hospital Organization Tokyo Medical Center, Tokyo, Japan
Yukie Sunata: Department of Gastroenterology, National Hospital Organization Tokyo Medical Center, Tokyo, Japan
Yuichiro Hirai: Department of Gastroenterology, National Hospital Organization Tokyo Medical Center, Tokyo, Japan
Tetsu Hirata: Department of Gastroenterology, National Hospital Organization Tokyo Medical Center, Tokyo, Japan
Yoshiaki Takada: Department of Gastroenterology, National Hospital Organization Tokyo Medical Center, Tokyo, Japan
Michiko Wada: Department of Gastroenterology, National Hospital Organization Tokyo Medical Center, Tokyo, Japan
Yusaku Takatori: Department of Gastroenterology, National Hospital Organization Tokyo Medical Center, Tokyo, Japan
Shigeo Banno: Department of Gastroenterology, National Hospital Organization Tokyo Medical Center, Tokyo, Japan
Satoshi Kinoshita: Department of Gastroenterology, National Hospital Organization Tokyo Medical Center, Tokyo, Japan
Hideki Mori: Department of Gastroenterology, National Hospital Organization Tokyo Medical Center, Tokyo, Japan
Kaoru Takabayashi: Department of Gastroenterology, National Hospital Organization Tokyo Medical Center, Tokyo, Japan
Masahiro Kikuchi: Department of Gastroenterology, National Hospital Organization Tokyo Medical Center, Tokyo, Japan
Junichi Shiraishi: Department of Pathology, National Hospital Organization Tokyo Medical Center, Tokyo, Japan
Toshio Uraoka: Department of Gastroenterology, National Hospital Organization Tokyo Medical Center, Tokyo, Japan

DOI: https://doi.org/10.1055/a-0621-4445
Journal volume & issue: Vol. 06, no. 08
pp. E934 – E940

Abstract

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Background and study aims Although cold polypectomy (CP) is widely used for colorectal polyps 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.

Published in Endoscopy International Open

ISSN: 2364-3722 (Print); 2196-9736 (Online)
Publisher: Georg Thieme Verlag KG
Country of publisher: Germany
LCC subjects: Medicine: Internal medicine: Specialties of internal medicine: Diseases of the digestive system. Gastroenterology
Website: https://doi.org/10.1055/s-00025476

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