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CC BY 4.0 · Endosc Int Open 2025; 13: a25442654
DOI: 10.1055/a-2544-2654
Original article

Efficacy of water pressure method for colorectal endoscopic submucosal dissection: Propensity-score matching analysis

Authors

  • Kumiko Kirita 

    1   Department of Gastroenterology, Nippon Medical School Chiba Hokusoh Hospital, Inzai-city, Japan (Ringgold ID: RIN38626)

  • Teppei Akimoto 

    1   Department of Gastroenterology, Nippon Medical School Chiba Hokusoh Hospital, Inzai-city, Japan (Ringgold ID: RIN38626)

  • Masahiro Niikawa

    1   Department of Gastroenterology, Nippon Medical School Chiba Hokusoh Hospital, Inzai-city, Japan (Ringgold ID: RIN38626)

  • Keiichiro Yoshikata

    2   Department of Gastroenterology, Nippon Medical School, Bunkyo-ku, Japan (Ringgold ID: RIN26367)

  • Shun Nakagome

    2   Department of Gastroenterology, Nippon Medical School, Bunkyo-ku, Japan (Ringgold ID: RIN26367)

  • Tsugumi Habu 

    2   Department of Gastroenterology, Nippon Medical School, Bunkyo-ku, Japan (Ringgold ID: RIN26367)

  • Yumiko Ishikawa

    2   Department of Gastroenterology, Nippon Medical School, Bunkyo-ku, Japan (Ringgold ID: RIN26367)

  • Eriko Koizumi

    2   Department of Gastroenterology, Nippon Medical School, Bunkyo-ku, Japan (Ringgold ID: RIN26367)

  • Kazutoshi Higuchi 

    2   Department of Gastroenterology, Nippon Medical School, Bunkyo-ku, Japan (Ringgold ID: RIN26367)

  • Hiroto Noda

    2   Department of Gastroenterology, Nippon Medical School, Bunkyo-ku, Japan (Ringgold ID: RIN26367)

  • Takeshi Onda

    2   Department of Gastroenterology, Nippon Medical School, Bunkyo-ku, Japan (Ringgold ID: RIN26367)

  • Jun Omori

    2   Department of Gastroenterology, Nippon Medical School, Bunkyo-ku, Japan (Ringgold ID: RIN26367)

  • Naohiko Akimoto

    2   Department of Gastroenterology, Nippon Medical School, Bunkyo-ku, Japan (Ringgold ID: RIN26367)

  • Osamu Goto 

    2   Department of Gastroenterology, Nippon Medical School, Bunkyo-ku, Japan (Ringgold ID: RIN26367)

  • Shunji Fujimori

    1   Department of Gastroenterology, Nippon Medical School Chiba Hokusoh Hospital, Inzai-city, Japan (Ringgold ID: RIN38626)

  • Katsuhiko Iwakiri

    2   Department of Gastroenterology, Nippon Medical School, Bunkyo-ku, Japan (Ringgold ID: RIN26367)
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Abstract

Background and study aims

Technical difficulty of endoscopic submucosal dissection (ESD) for colorectal neoplasms has not been resolved. The water pressure method (WPM) is a helpful technique for overcome difficulties with colorectal ESD. We evaluated the efficacy and safety of ESD with WPM (WPM-ESD) for colorectal neoplasms compared with conventional ESD (C-ESD).

Patients and methods

This was a single-center, retrospective, observational study. Three hundred and eleven colorectal lesions were allocated into the WPM-ESD and the C-ESD groups, which were compared before and after propensity score matching. The main outcomes were procedure time, proportion of R0 resection, and incidence of adverse events (AEs) in the two groups.

Results

The WPM-ESD and C-ESD groups were allocated 134 and 177 lesions, respectively, and propensity score matching analysis created 92 matched pairs. Mean procedure time was significantly shorter in the WPM-ESD group (49 ± 26 vs. 58 ± 42 min, P = 0.032). All lesions were resected in one piece and there was no difference in the proportion of en bloc resection (100% vs. 100%) and R0 resection (92% vs. 96%, P = 0.536) or in incidence of intraoperative perforation (2.2% vs. 2.2%) in the two groups.

Conclusions

WPM for colorectal ESD may shorten procedure time compared with C-ESD without increasing AEs.

Keywords

Endoscopy Lower GI Tract - Colorectal cancer - Polyps / adenomas / ... - Endoscopic resection (polypectomy, ESD, EMRc, ...)


Publication History

Received: 15 August 2024

Accepted after revision: 14 February 2025

Accepted Manuscript online:
21 February 2025

Article published online:
04 April 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/).

Georg Thieme Verlag KG
Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany

Bibliographical Record
Kumiko Kirita, Teppei Akimoto, Masahiro Niikawa, Keiichiro Yoshikata, Shun Nakagome, Tsugumi Habu, Yumiko Ishikawa, Eriko Koizumi, Kazutoshi Higuchi, Hiroto Noda, Takeshi Onda, Jun Omori, Naohiko Akimoto, Osamu Goto, Shunji Fujimori, Katsuhiko Iwakiri. Efficacy of water pressure method for colorectal endoscopic submucosal dissection: Propensity-score matching analysis. Endosc Int Open 2025; 13: a25442654.
DOI: 10.1055/a-2544-2654
 

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