Underwater endoscopic mucosal resection of a rectal adenoma in the nondistensible rectum from severe fecal incontinence

Pattarajierapan, Sukit; Khomvilai, Supakij

doi:10.1016/j.vgie.2021.02.014

Cited by 2 publications

(1 citation statement)

References 2 publications

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“…One case report described UEMR for rectal adenoma in the non‐distensible rectum arising from severe fecal incontinence, 57 and indicated that UEMR can even be successful in situations where the performance of CEMR and ESD is difficult. However, some endoscopists remained skeptical about UEMR as a special procedure and investigated techniques to decrease the difficulty of UEMR in case reports that utilized peristalsis, 58 a snaring technique, 59 and a special device 60 .…”

Section: Uemr In Case Reports Under Special Situationsmentioning

confidence: 99%

Underwater endoscopic mucosal resection for colorectal lesions: Can it be an “Underwater” revolution?

2022

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Underwater endoscopic mucosal resection (UEMR) is a newly developed technique for the removal of colorectal, duodenal, esophageal, gastric, ampullary, and small intestinal lesions. We performed a PubMed literature search for articles reporting UEMR outcomes for colorectal polyps. Four randomized controlled trials, nine non‐randomized prospective trials, 16 retrospective studies, and 27 case reports were selected for assessment of the efficacy and safety of UEMR. We summarized the therapeutic outcomes of UEMR in each category according to the lesion characteristics [small size (<10 mm), intermediate size (10–19 mm), large size (≥20 mm), recurrent lesion, and rectal neuroendocrine tumor], and calculated the incidence of adverse events among the included articles. As the treatment outcomes for small polyps appeared similar between UEMR and conventional endoscopic mucosal resection (CEMR), UEMR can be a standard procedure for small colorectal polyps suspicious for high‐grade dysplasia to avoid incomplete removal of occult invasive cancer by cold snare polypectomy. As UEMR showed satisfactory outcomes for intermediate‐size lesions and recurrent lesions after endoscopic resection, UEMR can be a standard procedure for these lesions. Regarding large lesions and rectal neuroendocrine tumors, comparisons of UEMR with current standard methods for them were lacking, and further investigations are warranted. Adverse events appeared comparable or less frequent for UEMR compared with CEMR but still existed. Therefore, careful implementation of this new technique in clinical practice is important for its widespread use.

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