BACKGROUND: Underwater endoscopic mucosal resection without submucosal injection has been described for removing large flat colorectal lesions. OBJECTIVE: We aim to evaluate the reproducibility of this technique in terms of ease of implementation, safety and efficacy. METHODS: A prospective observational study of consecutive underwater endoscopic mucosal resection in a community hospital was performed. RESULTS: From September 2014 to April 2015, 25 flat or sessile colorectal lesions (median size 22.8 mm, range 10-50 mm; 18 placed in the right colon) were removed in 25 patients. Two of the lesions were adenomatous recurrences on scar of prior resection and one was a recurrence on a surgical anastomosis. The resection was performed en bloc in 76% of the cases. At the pathological examination, 14 lesions (56%) had advanced histology and seven (28%) were sessile serrated adenomas (two with high-grade dysplasia). Complete resection was observed in all the lesions removed en bloc. Intra-procedural bleeding was observed in two cases; both were managed endoscopically and were uneventful. No major adverse events occurred. CONCLUSION: Underwater endoscopic mucosal resection appears to be an easy, safe and effective technique in a community setting. Further studies evaluating the efficacy of the technique (early and late recurrence), as well as comparing it with traditional mucosal resection, are warranted.
BACKGROUND: Underwater endoscopic mucosal resection without submucosal injection has been described for removing large flat colorectal lesions. OBJECTIVE: We aim to evaluate the reproducibility of this technique in terms of ease of implementation, safety and efficacy. METHODS: A prospective observational study of consecutive underwater endoscopic mucosal resection in a community hospital was performed. RESULTS: From September 2014 to April 2015, 25 flat or sessile colorectal lesions (median size 22.8 mm, range 10-50 mm; 18 placed in the right colon) were removed in 25 patients. Two of the lesions were adenomatous recurrences on scar of prior resection and one was a recurrence on a surgical anastomosis. The resection was performed en bloc in 76% of the cases. At the pathological examination, 14 lesions (56%) had advanced histology and seven (28%) were sessile serrated adenomas (two with high-grade dysplasia). Complete resection was observed in all the lesions removed en bloc. Intra-procedural bleeding was observed in two cases; both were managed endoscopically and were uneventful. No major adverse events occurred. CONCLUSION: Underwater endoscopic mucosal resection appears to be an easy, safe and effective technique in a community setting. Further studies evaluating the efficacy of the technique (early and late recurrence), as well as comparing it with traditional mucosal resection, are warranted.
Authors: Sergey V Kantsevoy; Douglas G Adler; Jason D Conway; David L Diehl; Francis A Farraye; Richard Kwon; Petar Mamula; Sarah Rodriguez; Raj J Shah; Louis Michel Wong Kee Song; William M Tierney Journal: Gastrointest Endosc Date: 2008-07 Impact factor: 9.427
Authors: Kenneth F Binmoeller; Christopher M Hamerski; Janak N Shah; Yasser M Bhat; Steven D Kane; Richard Garcia-Kennedy Journal: Gastrointest Endosc Date: 2015-03 Impact factor: 9.427
Authors: Andrew Y Wang; Mary M Flynn; James T Patrie; Dawn G Cox; Wissam Bleibel; James A Mann; Bryan G Sauer; Vanessa M Shami Journal: Surg Endosc Date: 2014-04 Impact factor: 4.584
Authors: A W Yen; A Amato; S Cadoni; S Friedland; Y H Hsieh; J W Leung; M Liggi; J Sul; F W Leung Journal: Surg Endosc Date: 2018-10-17 Impact factor: 4.584