Case Report
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Dec 7, 2020; 26(45): 7258-7262
Published online Dec 7, 2020. doi: 10.3748/wjg.v26.i45.7258
Endoscopic mucosal ablation - an alternative treatment for colonic polyps: Three case reports
Antonio Mendoza Ladd, Joaquin Espinoza, Cesar Garcia
Antonio Mendoza Ladd, Department of Internal Medicine, Division of Gastroenterology, Texas Tech University Health Sciences Center, Paul L Foster School of Medicine, El Paso, TX 79905, United States
Joaquin Espinoza, Escuela de Medicina Luis Razetti, Universidad Central de Venezuela, Caracas 999188, Venezuela
Cesar Garcia, Department of Endoscopy, University Medical Center of El Paso, El Paso, TX 79905, United States
Author contributions: Mendoza Ladd A performed all the procedures, edited the video, drafted, edited and approved the final manuscript; Espinoza J and Garcia C drafted, edited and approved the final manuscript.
Informed consent statement: The study was considered exempt from needing to obtain informed consent. The IRB acknowledges that this project meets the criteria for exemption from formal IRB review in accordance with 45 CFR46.104 (d)(4)(iii). A Waiver of HIPAA Authorization for Research approved under 45 CFR164.512 (i)(2)(ii).
Conflict-of-interest statement: Antonio Mendoza Ladd has received fees for serving as a consultant for CONMED; Joaquin Espinoza and Cesar Garcia no conflicts of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Antonio Mendoza Ladd, FACG, FASGE, Assistant Professor, Department of Internal Medicine, Division of Gastroenterology, Texas Tech University Health Sciences Center, Paul L Foster School of Medicine, 4800 Alberta Avenue, El Paso, TX 79905, United States. dr_ladd25@yahoo.com
Received: September 26, 2020
Peer-review started: September 26, 2020
First decision: November 8, 2020
Revised: November 9, 2020
Accepted: November 21, 2020
Article in press: November 21, 2020
Published online: December 7, 2020
Abstract
BACKGROUND

Endoscopic resection of non-invasive lesions is now the standard of care for lesions in the GI tract. However, resection techniques require extensive training, are not available in all endoscopy centers and are prone to complications. Endoscopic mucosal ablation (EMA) is a combination of resection and ablation techniques and it may offer an alternative in the management of such lesions.

CASE SUMMARY

In this case series we report the successful treatment of three flat colonic polyps using the EMA technique. Two lesions were treatment naïve and 1 was a recurrence after an endoscopic mucosal resection. The sizes ranged from 2 to 4 cm. All three polyps were ablated successfully with no immediate or delayed complications. The recurrence rate at 1 year of follow up was 0%.

CONCLUSION

Based on this initial experience, we conclude that EMA is a safe and effective technique for the treatment of non-invasive colonic polyps when endoscopic resection techniques are not available.

Keywords: Endoscopy, Mucosal ablation, Colon polyp, Argon plasma coagulation, Alternative, Safe, Case report

Core Tip: Endoscopic resection via endoscopic mucosal resection or endoscopic submucosal dissection is currently the standard of care for non-invasive colonic polyps. However, these resection techniques require extensive training, are not available in all endoscopy centers, and are prone to adverse events such as perforation and bleeding. Endoscopic mucosal ablation appears to be a safe and effective alternative in the treatment of colonic polyps without invasive features.