Two-stage endoscopic mucosal resection is a safe and effective salvage therapy after a failed single-session approach

Abstract

Background and study aims Endoscopic mucosal resection (EMR) of laterally spreading colonic lesions ≥20mm (LSLs) is ideally performed in a single session (ssEMR) and avoids surgery in>90% of patients. We investigated whether a second attempt is safe or useful when ssEMR fails at a tertiary center. Patients and methods In a multicenter prospective observational study of patients with LSL treated by EMR at four tertiary centers over 8 years, incompletely resected LSLs were referred for surgery or underwent two-stage EMR (tsEMR). At tsEMR, the scar was located and all visible residual tissue removed by snare, with thermal treatment permitted thereafter. Scheduled surveillance was performed at 5..