Endoscopic Mucosal Resection: First-Line Treatment for Laterally Spreading Lesions at Anorectal Junction
Douglas K. Rex, MD, FASGE reviewing Shahidi N, et al. Gut 2019 Nov 12.
Laterally spreading lesions at the anorectal junction can be treated by endoscopic mucosal resection (EMR), endoscopic submucosal dissection (ESD), or transanal surgical resection. In a study of 100 EMRs of anorectal junction lesions (distal margin, ≤20 mm from the dentate line) compared to rectal lesions (distal margin, >20 mm from the dentate line), technical success of EMR was 98%, recurrence rates were low and not different for anorectal versus rectal lesions, delayed hemorrhage occurred in 11.1% of the anorectal lesions, and submucosal cancer was identified in 3% of the patients.
Note to readers: At the time we reviewed this paper, its publisher noted that it was not in final form and that subsequent changes might be made.
Douglas K. Rex, MD, FASGE
Shahidi N, Sidhu M, Vosko S, et al. Endoscopic mucosal resection is effective for laterally spreading lesions at the anorectal junction. Gut 2019 Nov 12. (Epub ahead of print) (https://doi.org/10.1136/gutjnl-2019-319785)