Underwater endoscopic mucosal resection is associated with fewer recurrences and earlier curative resections compared to conventional endoscopic mucosal resection for ... View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2017-03-24

AUTHORS

Robert J. Schenck, Darius A. Jahann, James T. Patrie, Edward B. Stelow, Dawn G. Cox, Dushant S. Uppal, Bryan G. Sauer, Vanessa M. Shami, Daniel S. Strand, Andrew Y. Wang

ABSTRACT

BackgroundStudies comparing the efficacy and safety of conventional saline-assisted piecemeal endoscopic mucosal resection (EMR) to underwater EMR (UEMR) without submucosal lifting of colorectal polyps are lacking. The objective of this study was to compare the efficacy and safety of EMR to UEMR of large colorectal polyps.MethodsTwo hundred eighty-nine colorectal polyps were removed by a single endoscopist from 7/2007 to 2/2015 using EMR or UEMR. 135 polyps (EMR: 62, UEMR: 73) that measured ≥15 mm and had not undergone prior attempted polypectomy were evaluated for rates of complete macroscopic resection and adverse events. 101 of these polyps (EMR: 46, UEMR: 55) had at least 1 follow-up colonoscopy and were studied for rates of recurrence and the number of procedures required to achieve curative resection.ResultsThe rate of complete macroscopic resection was higher following UEMR compared to EMR (98.6 vs. 87.1%, p = 0.012). UEMR had a lower recurrence rate at the first follow-up colonoscopy compared to EMR (7.3 vs. 28.3%, OR 5.0 for post-EMR recurrence, 95% CI: [1.5, 16.5], p = 0.008). UEMR required fewer procedures to reach curative resection than EMR (mean of 1.0 vs. 1.3, p = 0.002). There was no significant difference in rates of adverse events.ConclusionsUEMR appears superior to EMR for the removal of large colorectal polyps in terms of rates of complete macroscopic resection and recurrent (or residual) abnormal tissue. Compared to conventional EMR, UEMR may offer increased procedural effectiveness without compromising safety in the removal of large colorectal polyps without prior attempted resection. More... »

PAGES

4174-4183

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00464-017-5474-4

DOI

http://dx.doi.org/10.1007/s00464-017-5474-4

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1084022222

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/28342125


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