title: Predictors of complete endoscopic mucosal resection of flat and depressed gastrointestinal neoplasia of the colon.
abstract: OBJECTIVE
  We evaluated risk factors for residual neoplasia on first follow-up endoscopy after colonic endoscopic mucosal resections (EMRs).
  
  
  METHODS
  This retrospective study in a high-volume EMR tertiary-referral center examined EMRs on 423 colonic lesions in 313 patients.
  
  
  RESULTS
  Residual neoplasia at first follow-up endoscopy was present following 12% of colonic EMRs. Single-variable analysis showed evidence of an increased risk of residual neoplasia for larger polyps, polyps without a lifting sign, and polyps removed piecemeal. In multivariable analysis, only use of the piecemeal method was independently associated with residual neoplasia.
  
  
  CONCLUSIONS
  Additional procedures are needed to complete resection in more than 1 in 10 colonic EMRs. Residual neoplasia occurs more often with piecemeal resection. Close surveillance after EMR and the use of newer methods to further reduce residual neoplasia are needed.
authors.affiliation: Department of Gastroenterology, Mayo Clinic, 4500 San Pablo Road South, Jacksonville, Florida 32224, USA. woodward.timothy@mayo.edu
authors.forename: Timothy A
authors.initials: TA
authors.lastname: Woodward
authors.forename: Michael G
authors.initials: MG
authors.lastname: Heckman
authors.forename: Patrick
authors.initials: P
authors.lastname: Cleveland
authors.forename: Silvio
authors.initials: S
authors.lastname: De Melo
authors.forename: Massimo
authors.initials: M
authors.lastname: Raimondo
authors.forename: Michael
authors.initials: M
authors.lastname: Wallace
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003110:Colonic Neoplasms / Q000473:pathology / Q000601:surgery*; D003111:Colonic Polyps / Q000473:pathology / Q000601:surgery*; D016099:Endoscopy, Gastrointestinal; D005260:Female; D006801:Humans; D007413:Intestinal Mucosa / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D018365:Neoplasm, Residual; D055815:Young Adult