Modified underwater endoscopic mucosal resection for intermediate-sized sessile colorectal polyps
IntroductionUnderwater endoscopic mucosal resection (UEMR) is effective for treating intermediate-sized colorectal polyps. However, it is sometimes difficult to obtain visibility in underwater conditions.MethodsThis prospective, observational, single-center study included consecutive patients with i...
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| Format: | Article |
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Frontiers Media S.A.
2023-06-01
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| Series: | Frontiers in Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fmed.2023.1200145/full |
| _version_ | 1797799545221939200 |
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| author | Dong Hyun Kim Seon-Young Park Hye-Su You Yong-Wook Jung Young-Eun Joo Dae-Seong Myung Hyun-Soo Kim Nah Ihm Kim Seong-Jung Kim Jae Kyun Ju |
| author_facet | Dong Hyun Kim Seon-Young Park Hye-Su You Yong-Wook Jung Young-Eun Joo Dae-Seong Myung Hyun-Soo Kim Nah Ihm Kim Seong-Jung Kim Jae Kyun Ju |
| author_sort | Dong Hyun Kim |
| collection | DOAJ |
| description | IntroductionUnderwater endoscopic mucosal resection (UEMR) is effective for treating intermediate-sized colorectal polyps. However, it is sometimes difficult to obtain visibility in underwater conditions.MethodsThis prospective, observational, single-center study included consecutive patients with intermediate-sized (10–20 mm) sessile colorectal polyps. Modified UEMR method was used to initially snare the lesion without injection or water infusion. Thereafter, water was infused until the lesion was submerged, then it was resected using electrocautery. We also evaluated the rates of complete resection and procedure-related complications.ResultsForty-two patients with 47 polyps were enrolled in the study. The median procedure time and fluid infusion were 71 s (42–607) and 50 mL (30–130), respectively. The rates of R0 resection and en bloc resection were 80.9 and 97.9%, respectively, with 100% technical success. R0 resection was observed in 42.9% of polyps sized ≥15 mm and 87.5% sized <15 mm (p < 0.01). Muscle entrapment was found in 71.4% of patients with polyps sized ≥15 mm and 10% <15 mm (p < 0.01). Immediate bleeding occurred in 12.8% of cases and was controlled using a snare tip or hemostatic forceps. Snare-tip ablation and hemostatic forceps ablation were performed in 27.7 and 6.4% of patients, respectively. No delayed bleeding, perforation, or any other complications were reported.ConclusionModified UEMR can be used in cases in which securing visibility or performing the existing UEMR is challenging. Careful treatment is required when removing polyps >15 mm in size. |
| first_indexed | 2024-03-13T04:20:28Z |
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| institution | Directory Open Access Journal |
| issn | 2296-858X |
| language | English |
| last_indexed | 2024-03-13T04:20:28Z |
| publishDate | 2023-06-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Medicine |
| spelling | doaj.art-28341d1dbbec415b90c2cd10bfb868fd2023-06-20T10:08:01ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2023-06-011010.3389/fmed.2023.12001451200145Modified underwater endoscopic mucosal resection for intermediate-sized sessile colorectal polypsDong Hyun Kim0Seon-Young Park1Hye-Su You2Yong-Wook Jung3Young-Eun Joo4Dae-Seong Myung5Hyun-Soo Kim6Nah Ihm Kim7Seong-Jung Kim8Jae Kyun Ju9Division of Gastroenterology and Hepatology, Department of Internal Medicine, Chonnam National University Hospital and Medical School, Gwangju, Republic of KoreaDivision of Gastroenterology and Hepatology, Department of Internal Medicine, Chonnam National University Hospital and Medical School, Gwangju, Republic of KoreaDivision of Gastroenterology and Hepatology, Department of Internal Medicine, Chonnam National University Hospital and Medical School, Gwangju, Republic of KoreaDivision of Gastroenterology and Hepatology, Department of Internal Medicine, Chonnam National University Hospital and Medical School, Gwangju, Republic of KoreaDivision of Gastroenterology and Hepatology, Department of Internal Medicine, Chonnam National University Hospital and Medical School, Gwangju, Republic of KoreaDivision of Gastroenterology and Hepatology, Department of Internal Medicine, Chonnam National University Hospital and Medical School, Gwangju, Republic of KoreaDivision of Gastroenterology and Hepatology, Department of Internal Medicine, Chonnam National University Hospital and Medical School, Gwangju, Republic of KoreaDepartment of Pathology, Chonnam National University Hospital and Medical School, Gwangju, Republic of KoreaDivision of Gastroenterology and Hepatology, Department of Internal Medicine, Chosun University Hospital, Gwangju, Republic of KoreaDivision of Colorectal Surgery, Department of Surgery, Chonnam National University Hospital and Medical School, Gwangju, Republic of KoreaIntroductionUnderwater endoscopic mucosal resection (UEMR) is effective for treating intermediate-sized colorectal polyps. However, it is sometimes difficult to obtain visibility in underwater conditions.MethodsThis prospective, observational, single-center study included consecutive patients with intermediate-sized (10–20 mm) sessile colorectal polyps. Modified UEMR method was used to initially snare the lesion without injection or water infusion. Thereafter, water was infused until the lesion was submerged, then it was resected using electrocautery. We also evaluated the rates of complete resection and procedure-related complications.ResultsForty-two patients with 47 polyps were enrolled in the study. The median procedure time and fluid infusion were 71 s (42–607) and 50 mL (30–130), respectively. The rates of R0 resection and en bloc resection were 80.9 and 97.9%, respectively, with 100% technical success. R0 resection was observed in 42.9% of polyps sized ≥15 mm and 87.5% sized <15 mm (p < 0.01). Muscle entrapment was found in 71.4% of patients with polyps sized ≥15 mm and 10% <15 mm (p < 0.01). Immediate bleeding occurred in 12.8% of cases and was controlled using a snare tip or hemostatic forceps. Snare-tip ablation and hemostatic forceps ablation were performed in 27.7 and 6.4% of patients, respectively. No delayed bleeding, perforation, or any other complications were reported.ConclusionModified UEMR can be used in cases in which securing visibility or performing the existing UEMR is challenging. Careful treatment is required when removing polyps >15 mm in size.https://www.frontiersin.org/articles/10.3389/fmed.2023.1200145/fullcolonic polypsendoscopic mucosal resectionendoscopywaterneoplasm (MeSH term) |
| spellingShingle | Dong Hyun Kim Seon-Young Park Hye-Su You Yong-Wook Jung Young-Eun Joo Dae-Seong Myung Hyun-Soo Kim Nah Ihm Kim Seong-Jung Kim Jae Kyun Ju Modified underwater endoscopic mucosal resection for intermediate-sized sessile colorectal polyps Frontiers in Medicine colonic polyps endoscopic mucosal resection endoscopy water neoplasm (MeSH term) |
| title | Modified underwater endoscopic mucosal resection for intermediate-sized sessile colorectal polyps |
| title_full | Modified underwater endoscopic mucosal resection for intermediate-sized sessile colorectal polyps |
| title_fullStr | Modified underwater endoscopic mucosal resection for intermediate-sized sessile colorectal polyps |
| title_full_unstemmed | Modified underwater endoscopic mucosal resection for intermediate-sized sessile colorectal polyps |
| title_short | Modified underwater endoscopic mucosal resection for intermediate-sized sessile colorectal polyps |
| title_sort | modified underwater endoscopic mucosal resection for intermediate sized sessile colorectal polyps |
| topic | colonic polyps endoscopic mucosal resection endoscopy water neoplasm (MeSH term) |
| url | https://www.frontiersin.org/articles/10.3389/fmed.2023.1200145/full |
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