title: Endoscopic mucosal resection of colorectal polyps in typical UK hospitals.
abstract: OBJECTIVE
  To evaluate the outcomes of endoscopic mucosal resection (EMR) for colorectal polyps, with particular regard to procedural complications and recurrence rate, in typical United Kingdom (UK) hospitals that perform an average of about 25 colonic EMRs per year.
  
  
  METHODS
  A total of 239 colorectal polyps (≥ 10 mm) resected from 199 patients referred to Rochdale Infirmary, Salford Royal Hospital and Royal Oldham Hospital for EMR between January 2003 and January 2009 were studied.
  
  
  RESULTS
  The mean size of polyps resected was 19.6 ± 12.4 mm (range 10-80 mm). The overall major complication rate was 2.1%. Complications were less frequent with non-adenomas compared with the other groups (Pearson's χ(2) test, P < 0.0001). Resections of larger-sized polyps were more likely to result in complications (unpaired t-test, P = 0.021). Recurrence was associated with histology, with carcinoma-in-situ more likely to recur compared with low-grade dysplasia [hazard ratio (HR) 186.7, 95% confidence interval (95% CI): 8.81-3953.02, P = 0.001]. Distal lesions were also more likely to recur compared with right-sided and transverse colon lesions (HR 5.93, 95% CI: 1.35-26.18, P = 0.019).
  
  
  CONCLUSIONS
  EMR for colorectal polyps can be performed safely and effectively in typical UK hospitals. Stricter follow-up is required for histologically advanced lesions due to increased recurrence risk.
authors.affiliation: Department of Gastroenterology and Medicine, Rochdale Infirmary, Whitehall Street, Rochdale, OL12 0NB, United Kingdom. reinalim@doctors.net.uk
authors.forename: Teegan R
authors.initials: TR
authors.lastname: Lim
authors.forename: Venkat
authors.initials: V
authors.lastname: Mahesh
authors.forename: Salil
authors.initials: S
authors.lastname: Singh
authors.forename: Benjamin H L
authors.initials: BH
authors.lastname: Tan
authors.forename: Mohamed
authors.initials: M
authors.lastname: Elsadig
authors.forename: Nerukav
authors.initials: N
authors.lastname: Radhakrishnan
authors.forename: Phil
authors.initials: P
authors.lastname: Conlong
authors.forename: Chris
authors.initials: C
authors.lastname: Babbs
authors.forename: Regi
authors.initials: R
authors.lastname: George
mesh_terms: D000368:Aged; D003111:Colonic Polyps / Q000473:pathology / Q000601:surgery*; D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D011183:Postoperative Complications; D012004:Rectal Neoplasms / Q000473:pathology / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome; D006113:United Kingdom