title: Endoscopic resection for superficial colorectal neoplasia in Italy: a prospective multicentre study.
abstract: BACKGROUND
  Since there are few prospective studies on colorectal endoscopic resection to date, we aimed to prospectively assess safety and efficacy of endoscopic resection in a cohort of Italian patients.
  
  
  METHODS
  Prospective multicentre assessment of resection of sessile polyps or non-polypoid lesions ≥10mm in size or smaller (if depressed). Outcome measures included complete excision, morbidity, mortality, and residual/recurrence at 12 months.
  
  
  RESULTS
  Overall, 1012 resections in 928 patients were analysed (62.4% sessile polyps, 28.8% laterally spreading tumours, 8.7% depressed non-polypoid lesions). Lesions were prevalent in the proximal colon. En bloc resection was possible in 715/1012 cases (70.7%), whereas piecemeal resection was required in 297 (29.3%). Endoscopically complete excision was achieved in 866 cases (85.6%). Adverse events occurred in 83 (8.2%), and no deaths occurred. Independent predictors of 12-month residual/recurrence were the location of the lesion in the proximal colon (OR 2.22 [95% CI 1.16-4.26]; p=0.015) and piecemeal endoscopic resection (OR 2.76 [95% CI 1.56-4.87]; p=0.0005). Limitations of the study were: potential expertise bias, no data on eligible and potentially resectable excluded lesions, high percentage of lesions<20mm, follow-up limited to 1 year.
  
  
  CONCLUSIONS
  In this registry study the endoscopic resection of colorectal lesions was safe and achieved high rates of long-term endoscopic clearance.
authors.affiliation: Gastroenterology, Hospital Maresca, Torre del Greco, Italy.
authors.forename: Livio
authors.initials: L
authors.lastname: Cipolletta
authors.affiliation: Gastroenterology, Hospital Maresca, Torre del Greco, Italy. Electronic address: gianluca.rotondano@virgilio.it.
authors.forename: Gianluca
authors.initials: G
authors.lastname: Rotondano
authors.affiliation: Gastroenterology, Hospital Maresca, Torre del Greco, Italy.
authors.forename: Maria A
authors.initials: MA
authors.lastname: Bianco
authors.affiliation: Gastroenterology, Azienda Ospedaliera di Cremona, Italy.
authors.forename: Federico
authors.initials: F
authors.lastname: Buffoli
authors.affiliation: Department of Internal Medicine and Gastroenterology, University of Bologna, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Gizzi
authors.affiliation: "Idea 99", Padua, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Tessari
mesh_terms: D000236:Adenoma / Q000601:surgery*; D000368:Aged; D002277:Carcinoma / Q000601:surgery*; D015331:Cohort Studies; D003111:Colonic Polyps / Q000601:surgery*; D003113:Colonoscopy / Q000379:methods*; D015179:Colorectal Neoplasms / Q000601:surgery*; D005260:Female; D006801:Humans; D007413:Intestinal Mucosa / Q000601:surgery*; D007558:Italy; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D011446:Prospective Studies; D016896:Treatment Outcome
keywords: Adverse events; Colorectal neoplasia; Endoscopic resection; Mucosectomy; Outcomes