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P289 Outcome of endoscopic ally resected dysplasic lesions in ulcerative colitis

Saoula H.*1, Boutaleb A.2, Mahiou H.2, Aissaoui M.2, Salah A.2, Belhocine K.3, Bounab N.3, Hamidouche D.2, Gamar L.3, Aissat Y.2, Zmiri Y.2, Mitiche A.2, Osmane R.2, Kecili L.3, Berkane S.3, Boucekkine T.3, Amir Z.c.4, Nakmouche M.2

1CHU of Bab El Oued, Epidemiology, Algiers, Algeria 2CHU of Bab El Oued, Gastroenterology, Algiers, Algeria 3CHU Mustapha, Gastroenterology, Algiers, Algeria 4CHU Mustapha, Pathology, Algiers, Algeria

Background

For a long time, dysplasic lesions in ulcerative colitis were only treated by surgery. Recent guidelines recommend the complete endoscopic resection of dysplasic lesions in ulcerative colitis.

The aim of this study was to determine the outcome of dysplasic lesions resected endoscopic ally in ulcerative colitis.

Methods

in this prospective study between january 2008 and january 2015; dysplasic lesions detected in patients with longstanding ulcerative colitis were assessed for their resecability, then when it was possible were resected. The patients were followed, and an endoscopic control was done at 6 month than every one year.

Results

36 dysplasic lesions were identified in 25 patients; 5 lesions were judged not resectable and reffered to surgery. 31 lesions were resected in 21 patients: 22 low grade dysplasia, 7 lesions indefinite for dysplasia, and 2 high grade dysplasia.

18 patients (85.7%) had endoscopic control: mean 2.8 (maximum: 5 minimum: 1).

2 patients refused next colonoscopy, one patient was not controlled because of a bad bowel preparation for 4 times.

In 13 patients (72.2%) no dysplasia was detected after a mean follow up of 30.16 months (marges: 7.56–62.5). Neoplasic lesions were found in 5 patients (27.7%): one adenocarcinoma of the sigmoid detected in a women that have had a high grade dysplasia resected in the sigmoid; in 3 patients new dysplasic lesions localized in other segments of the colon than those initially resected. in one patient a serrated rectal adenoma was found in the same place where was resected a serrated adenoma, reflecting an incomplete resection.

Conclusion

Our results confirm that a complete endoscopic resection may be sufficient in dysplasic lesions occurred in ulcerative colitis. Nevertheless a closer follow up is necessary because these patients may develop newer neoplasic lesions.