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Sigmoidoscopy and laparoscopy are distinct medical procedures that enable physicians to internally inspect different parts of the GI tract. Although they serve different purposes, each is essential for diagnosing and, in some cases, treating various medical conditions.
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The colon, or large intestine, is the final segment of the digestive system. Its primary functions include absorbing water and vitamins produced by gut bacteria and transforming waste from liquid to solid to form stool. In adults, the large intestine is approximately 5 feet long and consists of four main sections:
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Related Experiment Video

Updated: Jun 12, 2025

Use of the Scissor-Type Knife During the Peroral Endoscopy Myotomy Procedure for the Treatment of Achalasia
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Comparing Precutting Endoscopic Mucosal Resection Using Snare-Tip and Endoscopic Submucosal Dissection Knife for

Chang Kyo Oh1, Young Wook Cho2, Young-Seok Cho2

  • 1Division of Gastroenterology, Department of Internal Medicine, Kangnam Sacred Heart Hospital, Hallym University of Korea, Seoul, South Korea.

The American Journal of Gastroenterology
|May 14, 2025
PubMed
Summary

Precutting endoscopic mucosal resection (EMR-P) with a snare-tip is as effective and safe as using an endoscopic submucosal dissection (ESD) knife for large colorectal polyps. This finding supports the use of snare-tips in EMR-P procedures.

Keywords:
laterally spreading tumorsnonpedunculated polypsprecutting endoscopic mucosal resection

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Area of Science:

  • Gastroenterology
  • Endoscopic Surgery
  • Colorectal Cancer Prevention

Background:

  • Precutting endoscopic mucosal resection (EMR-P) is a technique for removing large nonpedunculated colorectal polyps.
  • EMR-P involves making an initial mucosal incision using either a snare-tip or an endoscopic submucosal dissection (ESD) knife.
  • Concerns exist regarding the comparative efficacy of snare-tips versus ESD knives in EMR-P.

Purpose of the Study:

  • To compare the efficacy and safety of EMR-P using a snare-tip versus an ESD knife.
  • To evaluate the en bloc resection rate as the primary outcome.
  • To assess procedural success and safety in treating large nonpedunculated colorectal polyps.

Main Methods:

  • A randomized controlled trial involving 106 patients with large nonpedunculated colorectal polyps (15-25 mm).
  • Polyps were randomly assigned to EMR-P using either a snare-tip or an ESD knife.
  • The primary endpoint was the en bloc resection rate; secondary outcomes included R0 resection, procedure time, and adverse events.

Main Results:

  • En bloc resection rates were similar between the snare-tip and ESD knife groups (98.1% vs 98.1%, P=1.000).
  • R0 resection rates (88.7% vs 92.5%, P=0.663) and procedure times (8.9 vs 9.3 minutes, P=0.550) were not significantly different.
  • No perforations occurred, and local recurrence rates were 0% in both groups.

Conclusions:

  • EMR-P using a snare-tip is non-inferior to EMR-P using an ESD knife for large nonpedunculated colorectal polyps.
  • The snare-tip is an effective and safe alternative to the ESD knife in EMR-P.
  • These findings support the broader application of snare-tips in EMR-P procedures.