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Underwater colorectal EMR: remodeling endoscopic mucosal resection
Gabriele Curcio1, Antonino Granata1, Dario Ligresti1
1Endoscopy Service, Department of Diagnostic and Therapeutic Services, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (ISMETT), Palermo, Italy.
Gastrointestinal Endoscopy
|March 10, 2015
Summary
Underwater Endoscopic Mucosal Resection (UEMR) effectively removes large colorectal polyps without submucosal injection. Skilled endoscopists can perform UEMR without specialized training, offering a safe alternative to traditional methods.
Area of Science:
- Gastroenterology
- Endoscopic procedures
- Colorectal cancer screening
Background:
- Underwater Endoscopic Mucosal Resection (UEMR) is a novel technique for removing large sessile colorectal polyps.
- This method eliminates the need for submucosal injection, simplifying the procedure.
Purpose of the Study:
- To assess the outcomes of UEMR for colorectal polyps.
- To determine if endoscopists skilled in traditional Endoscopic Mucosal Resection (EMR) can perform UEMR without dedicated training.
- To evaluate the necessity of Endoscopic Ultrasound (EUS) prior to UEMR.
Main Methods:
- A prospective, observational study was conducted at a single, tertiary-care referral center.
- Underwater Endoscopic Mucosal Resection (UEMR) was performed on 72 consecutive patients.
- Complete resection and adverse events were the primary outcome measures.
Main Results:
- 81 sessile colorectal polyps (mean size 18.7 mm) were treated with UEMR (mean time 11.8 minutes).
- Complete resection was achieved in all patients, with 68% removed en bloc and 32% piecemeal.
- No adverse events or recurrence were recorded during the follow-up period.
Conclusions:
- UEMR is an effective and safe alternative for treating colorectal lesions, performable by endoscopists skilled in conventional EMR.
- Endoscopic Ultrasound (EUS) may not be required for lesions without invasive features visible on high-definition narrow-band imaging.
- This technique has the potential to enhance the treatment of colorectal lesions.
