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CC BY-NC-ND 4.0 · Endosc Int Open 2022; 10(12): E1577-E1582
DOI: 10.1055/a-1955-3379
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Feasibility of progressive polyp contraction with underwater endoscopic mucosal resection in ≥ 20 mm superficial colorectal lesions

Masahiro Okada
1   Department of Medicine, Division of Gastroenterology, Jichi Medical University, Shimotsuke, Japan
,
Satoshi Shinozaki
1   Department of Medicine, Division of Gastroenterology, Jichi Medical University, Shimotsuke, Japan
2   Shinozaki Medical Clinic, Utsunomiya, Japan
,
Tatsuma Nomura
1   Department of Medicine, Division of Gastroenterology, Jichi Medical University, Shimotsuke, Japan
,
Yoshikazu Hayashi
1   Department of Medicine, Division of Gastroenterology, Jichi Medical University, Shimotsuke, Japan
,
Takaaki Morikawa
1   Department of Medicine, Division of Gastroenterology, Jichi Medical University, Shimotsuke, Japan
,
Masafumi Kitamura
1   Department of Medicine, Division of Gastroenterology, Jichi Medical University, Shimotsuke, Japan
,
Hisashi Fukuda
1   Department of Medicine, Division of Gastroenterology, Jichi Medical University, Shimotsuke, Japan
,
Munefumi Arita
3   Department of Surgery, Jichi Medical University, Shimotsuke, Japan
,
Takahito Takezawa
1   Department of Medicine, Division of Gastroenterology, Jichi Medical University, Shimotsuke, Japan
,
Keijiro Sunada
1   Department of Medicine, Division of Gastroenterology, Jichi Medical University, Shimotsuke, Japan
,
Alan Kawarai Lefor
3   Department of Surgery, Jichi Medical University, Shimotsuke, Japan
,
Hironori Yamamoto
1   Department of Medicine, Division of Gastroenterology, Jichi Medical University, Shimotsuke, Japan
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Abstract

Background and study aims Underwater endoscopic mucosal resection (UEMR) does not always result in en bloc resection of large colorectal lesions. The aim of this study was to demonstrate the feasibility of en bloc resection with progressive polyp contraction with underwater endoscopic mucosal resection (PP-CUE) of large, superficial colorectal lesions. The advantage of PP-CUE is to enable resection of a superficial non-polypoid lesion that is larger than the snare diameter.

Patients and methods Eleven consecutive lesions in ten patients who underwent UEMR with PP-CUE of large superficial colorectal lesions (20 mm or greater) were included.

Results The median lesion diameter was 24 mm (interquartile range [IQR], 20–24 mm). All lesions were larger than the 15-mm rotatable snare that was used. Median procedure time and PP-CUE time were 11 minutes (IQR, 8.5–12.3) and 2.3 minutes (IQR, 1.9–3.4), respectively. Pathological diagnoses of resected specimens included six adenomas, three sessile serrated lesions, and two slightly invasive submucosal carcinomas. En bloc and R0 resection rates were both 91 % (10/11). No adverse events occurred.

Conclusions PP-CUE is useful to resect superficial non-polypoid colorectal lesions 20 to 25 mm in diameter in an en bloc fashion.



Publication History

Received: 16 February 2022

Accepted after revision: 30 September 2022

Accepted Manuscript online:
05 October 2022

Article published online:
15 December 2022

© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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Comment to this article:

Endoscopy International Open – recently publishedEndoscopy 2023; 55(01): 105-105
DOI: 10.1055/a-1966-9237

 

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