Expanding Endoscopic Boundaries: Endoscopic Resection of Large Appendiceal Orifice Polyps With Endoscopic Mucosal Resection and Endoscopic Submucosal Dissection

Authors

Ankur P Patel
Mai A Khalaf
Margarita Riojas-Barrett
Tara Keihanian
Mohamed O Othman

Publication Date

5-16-2023

Journal

World Journal of Gastrointestinal Endoscopy

DOI

10.4253/wjge.v15.i5.386

PMID

37274558

PMCID

PMC10236978

PubMedCentral® Posted Date

5-16-2023

PubMedCentral® Full Text Version

Post-Print

Published Open-Access

yes

Keywords

Appendiceal orifice polyps, Endoscopic mucosal resection, Endoscopic submucosal dissection, Polyp resection, Adenomatous polyps, En bloc resection

Abstract

BACKGROUND: Large appendiceal orifice polyps are traditionally treated surgically. Recently, endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD) have been utilized as alternative resection techniques.

AIM: To evaluate the efficacy and safety of endoscopic resection techniques for the management of large appendiceal orifice polyps.

METHODS: This was a retrospective observational study conducted to assess the feasibility and safety of EMR and ESD for large appendiceal orifice polyps. This project was approved by the Baylor College of Medicine Institutional Review Board. Patients who underwent endoscopic resection of appendiceal orifice polyps ≥ 1 cm from 2015 to 2022 at a tertiary referral endoscopy center in the United States were enrolled. The main outcomes of this study included

RESULTS: A total of 19 patients were identified. Most patients were female (53%) and Caucasian (95%). The mean age was 63.3 ± 10.8 years, and the average body mass index was 28.8 ± 6.4. The mean polyp size was 25.5 ± 14.2 mm. 74% of polyps were localized to the appendix (at or inside the appendiceal orifice) and the remaining extended into the cecum. 68% of polyps occupied ≥ 50% of the appendiceal orifice circumference. The mean procedure duration was 61.6 ± 37.9 minutes. Polyps were resected

CONCLUSION: Our study highlights how endoscopic mucosal resection, endoscopic submucosal dissection, and hybrid procedures are all appropriate techniques with minimal adverse effects, further validating the utility of endoscopic procedures in the management of large appendiceal polyps.

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