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Outcomes of Underwater Endoscopic Mucosal Resection for Giant Colorectal Polyps: A Multicenter Study
Rahul Karna1,2, Natalie Wilson3, Amir S Seid4
1Division of Gastroenterology and HepatologyUniversity of MinnesotaMinneapolisMinnesotaUnited States.
Endoscopy International Open
|August 13, 2026
Summary
Underwater endoscopic mucosal resection (uEMR) is a feasible technique for removing giant colorectal polyps (≥40 mm). This study found uEMR achieved high technical success and an acceptable safety profile for these large polyps.
Area of Science:
- Gastroenterology
- Endoscopy
- Colorectal Surgery
Background:
- Underwater endoscopic mucosal resection (uEMR) is increasingly used for large non-pedunculated colorectal polyps (LNPCPs).
- Limited data exists on uEMR outcomes for giant colorectal polyps (≥40 mm).
Purpose of the Study:
- To evaluate the technical success, recurrence rates, and safety of uEMR for giant colorectal polyps.
- To identify predictors of technical success, recurrence, and severe adverse events (SAEs).
Main Methods:
- Multicenter retrospective study of adults with giant colorectal polyps (≥40 mm) undergoing uEMR.
- Data collected on technical success, en-bloc resection rates, recurrence, SAEs, and predictors.
Main Results:
- 137 giant polyps (mean size 47.6 mm) were analyzed. Technical success was 90.5% with an 11.7% en-bloc resection rate.
- Recurrence was observed in 8.7% of patients with follow-up.
- Severe adverse events occurred in 9.5%, primarily delayed bleeding.
Conclusions:
- uEMR is technically feasible for giant colorectal polyps.
- The technique demonstrates an acceptable safety profile and recurrence rate for this challenging polyp size.
