title: Multicenter study of endoscopic mucosal resection using 0.13% hyaluronic acid solution of colorectal polyps less than 20 mm in size.
abstract: OBJECTIVE
  Endoscopic mucosal resection (EMR) of colorectal polyps should be curative and safe. This study aimed to determine the efficacy and safety of colorectal EMR using 0.13% hyaluronic acid (HA) solution.
  
  
  METHODS
  This was a single-armed multicenter prospective open trial conducted at 11 Japanese institutions. Lesion characteristics and various measures of clinical outcome, including en bloc resection, histopathologically complete resection, and postoperative bleeding were analyzed for 624 consecutive patients who underwent EMR of colorectal polyps at ≤20 mm in size from August 2010 to September 2011.
  
  
  RESULTS
  En bloc and complete resection were achieved in 93.3 and 78.3% of 624 lesions. The median EMR procedure time was 2.1 ± 1.5 min. The rates of postoperative bleeding and perforation were 1.1 and 0%. The rate of en bloc resection was higher for polyps at 5-10 mm than for polyps at 11-20 mm (95.1 vs. 85.1%; P < 0.001) and was higher for protruding polyps than for superficial polyps (94.5 vs. 87.1%; P < 0.05). The rate of en bloc resection was also higher for polyps in the left-side colon than for those in the right-side colon or rectum (96.7 vs. 91.6 vs. 90.8%; P < 0.05). Multivariate analysis showed that polyp at 11-20 mm in size and location not on the left-side colon was significantly independent risk factors for failure of en bloc resection.
  
  
  CONCLUSIONS
  EMR using 0.13% HA of colorectal polyps less than 20 mm in size had high rates of en bloc and complete resection and few complications.
authors.affiliation: Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan. naohisa@koto.kpu-m.ac.jp
authors.forename: Naohisa
authors.initials: N
authors.lastname: Yoshida
authors.forename: Yuji
authors.initials: Y
authors.lastname: Naito
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Inada
authors.forename: Munehiro
authors.initials: M
authors.lastname: Kugai
authors.forename: Nobuaki
authors.initials: N
authors.lastname: Yagi
authors.forename: Ken
authors.initials: K
authors.lastname: Inoue
authors.forename: Takashi
authors.initials: T
authors.lastname: Okuda
authors.forename: Daisuke
authors.initials: D
authors.lastname: Hasegawa
authors.forename: Kazuyuki
authors.initials: K
authors.lastname: Kanemasa
authors.forename: Kassai
authors.initials: K
authors.lastname: Kyoichi
authors.forename: Kiichi
authors.initials: K
authors.lastname: Matsuyama
authors.forename: Takashi
authors.initials: T
authors.lastname: Ando
authors.forename: Toshiki
authors.initials: T
authors.lastname: Takemura
authors.forename: Seiji
authors.initials: S
authors.lastname: Shimizu
authors.forename: Naoki
authors.initials: N
authors.lastname: Wakabayashi
authors.forename: Akio
authors.initials: A
authors.lastname: Yanagisawa
authors.forename: Toshikazu
authors.initials: T
authors.lastname: Yoshikawa
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003113:Colonoscopy; D005260:Female; D006801:Humans; D006820:Hyaluronic Acid / Q000008:administration & dosage / Q000494:pharmacology*; D007413:Intestinal Mucosa / Q000187:drug effects / Q000473:pathology / Q000601:surgery*; D007417:Intestinal Polyps / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012007:Rectum / Q000187:drug effects / Q000473:pathology / Q000601:surgery; D012307:Risk Factors; D012996:Solutions; D055815:Young Adult
chemical_list: D012996:Solutions; D006820:Hyaluronic Acid