Colonic Endoscopic Resection of Adenomas (CERA) Program
The Parkview CERA program was developed in 2014, and is a subset program offering of the Interventional Endoscopic Oncology & Surgical Endoscopy (IOSE) division. The IOSE program was founded in 2013 at Parkview Health, and has continued to grow and develop into a regional leader in endoscopic oncology and minimally invasive therapeutic surgical endoscopy procedures and research.
After a large number of referrals and needs for resection of colon adenomas was identified, the IOSE program founded CERA to serve an unmet need in the region. Endoscopic Mucosal Resection, or EMR, is a therapeutic endoscopy procedure with varying degrees of complexity and subtleties. The CERA program is focused on colon EMR – an often underutilized treatment options for large colon adenomas that has lower recurrence rates than piecemeal polypectomy and less cost and morbidity for the patient than laparoscopic resection.
CERA serves to provide education to patients and physicians on the prevention of colon cancer and options for less invasive removal of large and flat colon adenomas through improved detection and the utilization of novel endoscopic mucosal resection techniques. The program has demonstrated value in reduction of cost for patients. It also has 5-year data on patient outcomes which, through IOSE’s CERA programs techniques for EMR, have demonstrated reduced morbidity and lower recurrence rates than alternative techniques and centers.
The CERA program now works as a collaboration between IOSE & the Parkview Cancer Institute, colorectal surgery and gastroenterology specialties focusing on those limited number of cases where complex polyps (adenomas) are identified requiring novel tools and techniques for removal.
Parkview Cancer Institute changes the way we care for patients with complex, flat or large precancerous colon polyps by using advanced endoscopic resection – part of the Interventional Endoscopic Oncology and Surgical Endoscopy program.
Our surgeons are fellowship trained in interventional endoscopy, with dedicated training to endoscopic resection. Gastrointestinal endoscopic mucosal resection is a non-invasive procedure to remove early-stage cancer or precancerous lesions found in the digestive track. Using an endoscope, our subspecialists can remove colon polyps that may have traditionally been removed with open surgery.
Upper GI tract lesions may also be referred for resection and are part of another program through IOSE referral. Some polyps may be excessively scarred down or requiring alternative removal options. Patients needing ESD, STER (submucosal dissection) or EFTR (full thickness resection) will be referred within IOSE to another subset program.
Lesions will be resected through IOSE with standard follow up. Patients will receive long-term, local colon cancer surveillance/colonoscopy with their referring physician.
In the event of invasive carcinoma, traditional laparoscopic, robotic-assisted or open surgery may be indicated. Parkview fellowship-trained colorectal surgeons are able to perform this surgery. Your subspecialized Parkview Cancer Institute care team will discuss treatment options at Tumor Board.
Benefits of CERA
The Parkview Cancer Institute CERA program offers innovative minimally invasive surgery as an alternative to open surgery when appropriate. Benefits of this approach include:
- Avoidance of major colon surgery
- Shorter surgical duration under sedation
- Shorter hospital stay
- Fellowship trained expertise and proficiency minimizes complication rates
- Reduced recovery time
- Lower cost than open surgical options
CERA Program Highlights
- We accept referrals for any adenoma. No adenomas/polyps are too small or too large for this program.
- Our interventional endoscopy fellowship-trained experts focus on EMR and have some of the highest volumes in the Midwest and nation for endoscopic mucosal resection.
- This allows a high level of expertise and proficiency using the latest techniques.
- We are involved in numerous research trials, national registries and publications for colon EMR, and our experts have taught this procedure at a national level.
- Our intent is to be a resource to aid all who are performing endoscopy – allowing these physicians to have a referral center for colon lesions (CERA program subset), and for upper GI tract lesions and lesions requiring other alternatives in advanced tissue resection (ESD, STER, EFTR) via a referral to another IOSE subprogram.
- If required, we also have IOSE subspecialist in ESD/STER/EFTR.
Meet Our Team
Neil Sharma, MD
Director, Interventional Endoscopic Oncology and Surgical Endoscopy
To refer to the CERA Program, Parkview/Community Connect providers should use REF248 – Ambulatory Referral to IOSE in EPIC.
External providers can refer by calling 833-PCI-TEAM.
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