Author commentary on Mitsuru Nagata et al.

Mitsuru Nagata et al. Prospective randomized trial comparing conventional and underwater endoscopic submucosal dissection for superficial colorectal neoplasms

The time taken to perform endoscopic submucosal dissection (ESD) remains a major obstacle. Recent case series have suggested that underwater ESD may improve resection speed. In this single-center randomized trial of 139 large colorectal lesions, underwater ESD did not speed up resection compared with conventional ESD; efficacy and safety outcomes were also not different. Despite this null result, the study provides important data on the potential complementarity of these two strategies, depending on gravity and lesion presentation, and questions the search for a single best strategy to fit all.

Publication History

Article published online:
22 April 2025