Underwater Endoscopic Mucosal Resection for Non-Pedunculated Colorectal Lesions. A Prospective Single-Arm Study

Lenz, Luciano; Martins, Bruno Costa; Kawaguti, Fábio S.; Tellian, Alexandre; Pennachi, Caterina Maria Pia Simoni; Sorbello, Mauricio; Gusmon, Carla; Paulo, Gustavo Andrade de; Uemura, Ricardo S.; Geiger, Sebastian; Lima, Marcelo Simas de; Safatle‐Ribeiro, Adriana Vaz; Baba, Elisa Ryoka; Hashimoto, Cláudio L.; Maluf‐Filho, Fauze; Ribeiro, Ulysses

doi:10.1590/s0004-2803.202000000-37

Cited by 5 publications

(4 citation statements)

References 21 publications

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“…In Brazil, there are few reports of UEMR. In the larger study (8) , 65 lesions were evaluated. The success rate was 98.5% and the en bloc resection was 61.5%.…”

Section: Discussionmentioning

confidence: 99%

“…The conventional endoscopic mucosal resection (CEMR) is the standard for treating sessile polyps with more than 9 mm of diameter (3) . Despite this technique is appropriated for most polyps, the submucosal injection may make snare capture more difficult (8) . Since 2012, a new technique for resection of large polyps has been described, the underwater endoscopic mucosal resection (UEMR) (9) .…”

Section: Introductionmentioning

confidence: 99%

“…Despite the current available data, there are few studies of UEMR in Brazil (8,14) and those are related to reference centers. This study aimed to evaluate the safety and efficacy of UEMR in sessile lesions in our center.…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of Underwater Endoscopic Mucosal Resection for Colorectal Polyps in an Outpatient Clinic in Brazil

Schacher

Braga

Severo

et al. 2021

Arq. Gastroenterol.

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BACKGROUND: Since 2012, a new technique for resection of large polyps has been described, the underwater endoscopic mucosal resection (UEMR). Some advantages that emerge from it is the needless of injection in submucosal layer and a greater chance of complete capture of the polyp. OBJECTIVE: There are few studies of UEMR in Brazil. The aim of this study is to evaluate the safety and efficacy of this technique in one Brazilian center. METHODS: This case series was conducted from February to December of 2020. Colorectal polyps greater than 9 mm without features of deep submucosal invasion were resected using UEMR. RESULTS: Twenty-four large polyps were resected with the UEMR approach from 24 patients. The mean size of the polys was 19 mm, ranging from 12 to 35 mm. All lesions were successful resected and 66% (16/24) were resected en bloc. In histologic analyses, most of them were adenomas (70.8%) and only one had deep submucosal invasion. There were no cases of acute complications, such perforation or acute bleeding. CONCLUSION: The UEMR is a safe and feasible procedure. With the emerging data on the procedure, it seems to be a wonderful tool in preventing colorectal cancer and its applicability and scope should be encourage to surpass reference centers.

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“…In Brazil, there are few reports of UEMR. In the larger study (8) , 65 lesions were evaluated. The success rate was 98.5% and the en bloc resection was 61.5%.…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Evaluation of Underwater Endoscopic Mucosal Resection for Colorectal Polyps in an Outpatient Clinic in Brazil

Schacher

Braga

Severo

et al. 2021

Arq. Gastroenterol.

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“…(6) Since the rst description of underwater EMR (UEMR) in 2012, many articles have been published showing reasonable technical success rates, with a low incidence of AEs with UEMR . (3,(5)(6)(7)(8)(9)(10)(11)(12) Previous meta-analyses have included lesions smaller than 10 mm, typically not removed by either CEMR or UEMR or non-randomized studies -inadequate for head-to-head comparisons. (1,(13)(14)(15)(16) The aim of this systematic review and meta-analysis is to evaluate and compare the e cacy and safety outcomes of UEMR and CEMR in lesions ≥ 10mm, analyzing only randomized controlled trials (RCT).…”

Section: Introductionmentioning

confidence: 99%

Underwater versus conventional endoscopic mucosal resection for colorectal lesions: a systematic review and meta-analysis of randomized clinical trials

Souza

Santo

Maluf‐Filho

et al. 2023

Int J Colorectal Dis

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Purpose: Conventional endoscopic mucosal resection (CEMR) is the established method for the resection of non-pedunculated colorectal lesions (NPCRL) ≥ 10mm. In the last decade, underwater endoscopic mucosal resection (UEMR) has been introduced as a potential alternative. The aim of this systematic review with meta-analysis is to compare the recurrence and safety of UEMR and CEMR by analyzing only randomized controlled trials (RCTs).Methods: We systematically searched PubMed, Cochrane Library and EMBASE until April 2023. Studies met the following inclusion criteria: (1) RCTs, (2) comparing UEMR with CEMR, (3) NPCRL ≥ 10 mm, and (4) reporting the outcomes of interest. Primary outcomes were recurrence and safety. Secondary outcomes were en bloc, R0, complete resection, clipping and adverse events per type.Results: Five RCTs were included. UEMR was associated with a lower recurrence rate (OR: 0.56; 95% CI: 0.32-0.97). Thus, the RR of recurrence was 1.7 times higher in the CEMR group (95% CI, 1.04-2.77). There was no signi cant difference in the pooled safety analysis. UEMR showed better en bloc resection rates (OR: 1.54; 95% CI: 1.15-2.07), but subgroup analysis showed comparable rates in lesions ≥20 mm. R0 resection was higher in UEMR (OR: 1.72; 95% CI: 1.23-2.41). Other outcomes were not different between the 2 groups.Conclusions: UEMR is as safe as CEMR, with a higher overall R0 rate and a higher en bloc resection rate for lesions < 20 mm, leading to a lower overall recurrence rate. The results of this meta-analysis support the widespread use of UEMR.

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Underwater versus conventional EMR for nonpedunculated colorectal lesions: a randomized clinical trial

Lenz¹,

Martins²,

Paulo³

et al. 2023

Gastrointestinal Endoscopy

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Underwater Endoscopic Mucosal Resection for Non-Pedunculated Colorectal Lesions. A Prospective Single-Arm Study

Cited by 5 publications

References 21 publications

Evaluation of Underwater Endoscopic Mucosal Resection for Colorectal Polyps in an Outpatient Clinic in Brazil

Evaluation of Underwater Endoscopic Mucosal Resection for Colorectal Polyps in an Outpatient Clinic in Brazil

Underwater versus conventional endoscopic mucosal resection for colorectal lesions: a systematic review and meta-analysis of randomized clinical trials

Underwater versus conventional EMR for nonpedunculated colorectal lesions: a randomized clinical trial

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