title: Laterally spreading tumors--experience based on 138 consecutive cases.
abstract: OBJECTIVE
  Laterally spreading tumors (LST) are flat elevated neoplastic lesions with diameters equal to or greater than 10 mm. The treatment results of 138 lesions in 131 patients are presented here as a part of a retrospective analysis.
  
  
  METHODS
  Two gastroenterology centers participated in the study in the period from 1/2002-12/2006. During colonoscopy, each superficial lesion was classified according to the Paris endoscopic classification. Endoscopic mucosal resection (EMR) lift and cut was employed. Treatment was considered successful when both endoscopic and histo-pathological criteria of complete resection were fulfilled.
  
  
  RESULTS
  A total of 138 LST in 131 patients were diagnosed. Average LST diameter was 25 mm. A total of 5 (3.6%) lesions in 4 patients were referred for primary surgery. One patient was treated with argon plasma coagulation only. EMR was attempted for 132/138 (95.7%) of all LST and was successful in 125 (90.6%) cases. Complications occured in 16/132 (12.1%) patients. Severe complications, defined as decession, emergency surgery, emergency endoscopy and transfusion of eryhrocyte concentrate occured in 5/132 (3.8%). One (0.7%) 69 year-old-male patient died on the third day following EMR due to complications of acute myocardial infarction.
  
  
  CONCLUSIONS
  LST lesions could be efficiently treated with EMR lift and cut method with a reasonable rate of complications.
authors.affiliation: Gastroenterology Department, Vitkovice Hospital, Ostrava-Vitkovice, Czech Republic. ondrej.urban@nemvitkovice.cz
authors.forename: Ondrej
authors.initials: O
authors.lastname: Urban
authors.forename: Petr
authors.initials: P
authors.lastname: Vitek
authors.forename: Petr
authors.initials: P
authors.lastname: Fojtik
authors.forename: Martin
authors.initials: M
authors.lastname: Kliment
authors.forename: David
authors.initials: D
authors.lastname: Janik
authors.forename: Josef
authors.initials: J
authors.lastname: Chalupa
authors.forename: Ales
authors.initials: A
authors.lastname: Albin
mesh_terms: D003110:Colonic Neoplasms / Q000601:surgery*; D003113:Colonoscopy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011351:Proctoscopy; D012004:Rectal Neoplasms / Q000601:surgery*; D012189:Retrospective Studies