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Why is the recurrence rate of residual or recurrent disease following endoscopic mucosal resection (EMR) of the oesophageal dysplasia s and T1 tumours higher in the Midlands Cancer Network?
6th Global Gastroenterologists Meeting
Harshadkumar Rajgor
University of Birmingham, UK
ScientificTracks Abstracts: J Gastrointest Dig Syst
Abstract
Background: Barrett’s oesophagus increases the risk of developing oesophageal adenocarcinoma. Over the last 40 years there has been a 6 fold increase in the incidence of oesophageal adenocarcinoma in the western world and the incidence rates are increasing at a greater rate than cancers of the colon, breast and lung. Endoscopic mucosal resection (EMR) is a relatively new technique being used by 2 centres in the Greater Midlands cancer network. EMR can be used for curative or staging purposes, for high grade dysplasias and T1 tumours of the oesophagus. EMR is also suitable for those who are deemed high risk for oesophagectomy. EMR has a recurrence rate of 21% according to the Wiesbaden data. Method: A retrospective study of prospectively collected data was carried out involving 24 patients who had EMR for curative or staging purposes. Complications of residual or recurrent disease following EMR that required further treatment were investigated. Results: In 54% of cases residual or recurrent disease was suspected. 96% of patients were given clear and concise information regarding their diagnosis of high grade dysplasia or T1 tumours. All 24 patients consulted the same specialist healthcare team. Conclusion: EMR is a safe and effective treatment for patients who have high grade dysplasia and T1NO tumours. In 54% of cases residual or recurrent disease was suspected. Initially only single resections were undertaken. Multiple resections are now being carried out to reduce the risk of recurrence. Complications from EMR remain low in this series and consisted of a single episode of post procedural bleeding. It is vitally important to carry out adequate resections to reduce recurrence rates.Biography
Harshadkumar Rajgor has completed his MBChB from The University of Birmingham Medical school, UK. He is currently a Core Surgical Trainee in prestigious East Midlands Deanery. He did many presentations at national and international level. He is actively involved in teaching of medical students.
Email: drhrajgor@gmail.com
