Underwater endoscopic mucosal resection for recurrences after previous piecemeal resection of colorectal polyps (with video)

Kim, Hyun Gun; Thosani, Nirav; Banerjee, Subhas; Chen, Ann; Friedland, Shai

doi:10.1016/j.gie.2014.05.318

Cited by 91 publications

(94 citation statements)

References 24 publications

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“…9 When the UEMR technique was used, the complete removal rate for recurrences was significantly higher compared with injection-assisted EMR (88.9% vs 31.8%, P < .001) in a nonrandomized clinical trial. 11 Furthermore, the recurrence rate was significantly lower in the UEMR group than the EMR group (10% vs 39.4%, P Z .02).…”

Section: Stomachmentioning

confidence: 82%

“…This method has also been reported to be effective in managing recurrences after previous EMR, as well as patients with previous partial resections and biopsies of lesions 10 because these interventions may result in submucosal fibrosis, making lifting of the lesion with submucosal injection difficult. [11][12][13][14][15][16][17][18] Adjunctive techniques Additional ablative techniques are used in an organspecific manner in addition to EMR for the ablation of residual tissue. In the esophagus, radiofrequency or cryoablation is frequently used to ablate additional Barrett's esophagus after EMR of the dysplastic lesions.…”

Section: Underwater Emrmentioning

confidence: 99%

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Endoscopic mucosal resection

Hwang¹,

Konda²,

Dayyeh³

et al. 2015

Gastrointestinal Endoscopy

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163

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EMR has become an established therapeutic option for premalignant and early-stage GI malignancies, particularly in the esophagus and colon. EMR can also aid in the diagnosis and therapy of subepithelial lesions localized to the muscularis mucosa or submucosa. Several dedicated EMR devices are available to facilitate these procedures. Adverse event rates, particularly bleeding and perforation, are higher after EMR relative to other basic endoscopic interventions but lower than adverse event rates for ESD. Endoscopists performing EMR should be knowledgeable and skilled in managing potential adverse events resulting from EMR.

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Section: Stomachmentioning

confidence: 82%

Section: Underwater Emrmentioning

confidence: 99%

Endoscopic mucosal resection

Hwang¹,

Konda²,

Dayyeh³

et al. 2015

Gastrointestinal Endoscopy

Self Cite

163

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show abstract

“…When the UEMR technique was used, the complete removal rate for recurrences was significantly higher compared with injection-assisted EMR (88.9 vs. 31.8%, p < 0.001) in a nonrandomized clinical trial [77]. Furthermore, the recurrence rate was significantly lower in the UEMR group than in the EMR group (10 vs. 39.4%, p < 0.02).…”

Section: Nonampullary Duodenal Adenomasmentioning

confidence: 91%

“…Although several studies have reported no recurrence after endoscopic removal of malignant colonic polyps, the effectiveness of EMR for the treatment of these lesions has been questioned, and EMR should not be attempted for nonlifting lesions or lesions classified as Paris II-c/III [16,[76][77][78][79][80][81][82]. However, nonlifting lesions that have previously been manipulated (biopsy or attempted EMR) before referral for resection are usually amenable to EMR [78].…”

Section: Nonampullary Duodenal Adenomasmentioning

confidence: 99%

Endoscopic Resection Techniques

Hoffman¹,

Heesen²,

Kollmar³

et al. 2017

Visc Med

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“…[1][2][3] One major advantage of U-EMR is that submucosal injection is not required as: (i) the suctioning of luminal air decreases colonic wall tension; (ii) colonic muscular wall remains circular when it is filled with water; and (iii) water immersion 'floats' the mucosa and submucosa. 2 This technique is also applied to duodenal ampullary and non-ampullary adenomas.…”

Section: Letters Techniques and Imagesmentioning

confidence: 99%