Tu1102 EFFICACY AND SAFETY OF COLD ENDOSCOPIC MUCOSAL RESECTION OF LARGE COLONIC ADENOMAS

Abstract Background Underwater endoscopic mucosal resection (UEMR) is a recently developed technique and can be performed during water-aided or ordinary colonoscopy for the treatment of colorectal polyps. The objective of this clinical trial was to evaluate the efficacy and safety of UEMR in comparison with conventional endoscopic mucosal resection (CEMR) of small non-pedunculated colorectal polyps. Methods Patients with small size, non-pedunculated colorectal polyps (4–9 mm in size) who underwent colonoscopic polypectomy were enrolled in this multicenter randomized controlled clinical trial. The patients were randomly allocated to two groups, an UEMR group and a CEMR group. Efficacy and safety were compared between groups. Results In the intention-to-treat (ITT) analysis, the complete resection rate was 83.1% (59/71) in the UEMR group and 87.3% (62/71) in the CEMR group. The en-bloc resection rate was 94.4% (67/71) in the UEMR group and 91.5% (65/71) in the CEMR group (difference 2.9%; 90% CI − 4.2 to 9.9%), showed noninferiority (noninferiority margin − 5.7% < − 4.2%). No significant difference in procedure time (81 s vs. 72 s, P = 0.183) was observed. Early bleeding was observed in 1.4% of patients in the CEMR group (1/71) and 1.4% of patients in the UEMR group (1/71). None of the patients in the UEMR group complained of postprocedural bloody stool, whereas two patients in the CEMR group (2/64) reported this adverse event. Conclusion Our results indicate that UEMR is safer and just as effective as CEMR in En-bloc resection for the treatment of small colorectal polyps as such, UEMR is recommended as an alternative approach to excising small and non-pedunculated colorectal adenomatous polyps. Trial registration Clinical Trials.gov, NCT03833492. Retrospectively registered on February 7, 2019.

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S1397: Efficacy and Safety of Endoscopic Mucosal Resection (EMR) of Duodenal Adenoma

Gastrointestinal Endoscopy ◽

10.1016/j.gie.2010.03.171 ◽

2010 ◽

Vol 71 (5) ◽

pp. AB150-AB151

Author(s):

Rupert Mayershofer ◽

Brigitte Schumacher ◽

Michael Philipper ◽

Horst Neuhaus

Keyword(s):

Endoscopic Mucosal Resection ◽

Efficacy And Safety ◽

Duodenal Adenoma ◽

Mucosal Resection

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Efficacy and safety of endoscopic mucosal resection of non-ampullary duodenal polyps: a systematic review

Endoscopy International Open ◽

10.1055/s-0042-107069 ◽

2016 ◽

Vol 04 (06) ◽

pp. E699-E708 ◽

Cited By ~ 9

Author(s):

Udayakumar Navaneethan ◽

Muhammad Hasan ◽

Vennisvasanth Lourdusamy ◽

Xiang Zhu ◽

Robert Hawes ◽

...

Keyword(s):

Systematic Review ◽

Endoscopic Mucosal Resection ◽

Efficacy And Safety ◽

Mucosal Resection ◽

Duodenal Polyps

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Sa1708 Efficacy and Safety of Endoscopic Mucosal Resection for Large Colorectal Polyps: A Meta-Analysis

Gastrointestinal Endoscopy ◽

10.1016/j.gie.2017.03.559 ◽

2017 ◽

Vol 85 (5) ◽

pp. AB248-AB249

Author(s):

Katherine Wong ◽

Elie S. Al Kazzi ◽

Saowonee Ngamruengphong

Keyword(s):

Endoscopic Mucosal Resection ◽

Meta Analysis ◽

Colorectal Polyps ◽

Efficacy And Safety ◽

Mucosal Resection ◽

Large Colorectal Polyps

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Mo1112 SLICING VERSUS LOOPING-EFFICACY AND SAFETY OF ENDOSCOPIC SUBMUCOSAL DISSECTION(ESD) VERSUS ENDOSCOPIC MUCOSAL RESECTION(EMR) IN PATIENTS WITH NON-PEDUNCULATED POLYPS LARGER THAN 20MM

Gastrointestinal Endoscopy ◽

10.1016/j.gie.2018.04.1873 ◽

2018 ◽

Vol 87 (6) ◽

pp. AB401

Author(s):

Andrew Ofosu ◽

Daryl Ramai ◽

Tagore Sunkara ◽

Emmanuel Ofori ◽

Paul J. Fields ◽

...

Keyword(s):

Endoscopic Submucosal Dissection ◽

Endoscopic Mucosal Resection ◽

Efficacy And Safety ◽

Mucosal Resection ◽

Submucosal Dissection

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The efficacy and safety of underwater endoscopic mucosal resection for ≥10-mm colorectal polyps: systematic review and meta-analysis

Endoscopy ◽

10.1055/a-1234-8918 ◽

2020 ◽

Author(s):

De-feng Li ◽

Ming-Guang Lai ◽

Mei-feng Yang ◽

Zhi-yuan Zou ◽

Jing Xu ◽

...

Keyword(s):

Endoscopic Mucosal Resection ◽

En Bloc Resection ◽

Bloc Resection ◽

Colorectal Polyps ◽

Complete Resection ◽

R0 Resection ◽

Efficacy And Safety ◽

Resection Rate ◽

En Bloc ◽

Mucosal Resection

Abstract Background Underwater endoscopic mucosal resection (UEMR) is a promising strategy for nonpedunculated colorectal polyp removal. However, the efficacy and safety of the technique for the treatment of ≥ 10-mm colorectal polyps remain unclear. We aimed to comprehensively assess the efficacy and safety of UEMR for polyps sized 10–19 mm and ≥ 20 mm. Methods PubMed, EMBASE, and the Cochrane Library databases were searched for relevant articles from January 2012 to November 2019. Primary outcomes were the rates of adverse events and residual polyps. Secondary outcomes were the complete resection, en bloc resection, and R0 resection rates. Results 18 articles including 1142 polyps from 1093 patients met our inclusion criteria. The overall adverse event and residual polyp rates were slightly lower for UEMR when removing colorectal polyps of 10–19 mm vs. ≥ 20 mm (3.5 % vs. 4.3 % and 1.2 % vs. 2.6 %, respectively). The UEMR-related complete resection rate was slightly higher for colorectal polyps of 10–19 mm vs. ≥ 20 mm (97.9 % vs. 92.0 %). However, the en bloc and R0 resection rates were dramatically higher for UEMR removal of polyps of 10–19 mm vs. ≥ 20 mm (83.4 % vs. 36.1 % and 73.0 % vs. 40.0 %, respectively). In addition, univariate meta-regression revealed that polyp size was an independent predictor for complete resection rate (P = 0.03) and en bloc resection (P = 0.01). Conclusions UEMR was an effective and safe technique for the removal of ≥ 10-mm nonpedunculated colorectal polyps. However, UEMR exhibited low en bloc and R0 resection rates for the treatment of ≥ 20-mm polyps.

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276 – Efficacy and Safety of Hot and Cold Endoscopic Mucosal Resection for Resection of Sessile Serrated Polyps: A Systematic Review and Pooled Analysis

Gastroenterology ◽

10.1016/s0016-5085(19)36920-3 ◽

2019 ◽

Vol 156 (6) ◽

pp. S-55

Author(s):

Viveksandeep Thoguluva Chandrasekar ◽

Abhiram Duvvuri ◽

Muhammad Aziz ◽

Chandra S. Dasari ◽

Ramprasad Jegadeesan ◽

...

Keyword(s):

Systematic Review ◽

Endoscopic Mucosal Resection ◽

Pooled Analysis ◽

Efficacy And Safety ◽

Serrated Polyps ◽

Mucosal Resection

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Efficacy and safety of modified endoscopic mucosal resection for rectal neuroendocrine tumors: a meta-analysis

Zeitschrift für Gastroenterologie ◽

10.1055/a-1062-8897 ◽

2020 ◽

Vol 58 (02) ◽

pp. 137-145 ◽

Cited By ~ 1

Author(s):

Jian-Chun Zheng ◽

Kai Zheng ◽

Shuai Zhao ◽

Zhen-Ning Wang ◽

Hui-Mian Xu ◽

...

Keyword(s):

Endoscopic Mucosal Resection ◽

Neuroendocrine Tumors ◽

Meta Analysis ◽

Complete Resection ◽

Lateral Margin ◽

Endoscopic Polypectomy ◽

Efficacy And Safety ◽

Margin Involvement ◽

Mucosal Resection ◽

Significant Difference

Abstract Purpose Rectal neuroendocrine tumors are rare with good prognosis. Several endoscopic methods such as endoscopic polypectomy, endoscopic submucosal dissection (ESD), endoscopic mucosal resection (EMR), and modified endoscopic mucosal resection (m-EMR) are used in the treatment of rectal neuroendocrine tumors. Although m-EMR is derived from traditional EMR, it has not been widely used in clinical practice. In this study, we compared the efficacy and safety of EMR and m-EMR in the treatment of rectal neuroendocrine tumors by performing a meta-analysis. Materials and Methods We searched PubMed, Web of Science, and EMBASE index up to the end of January 2017 for all published literature about EMR and m-EMR in the treatment of rectal neuroendocrine tumors. Results A total of 11 studies involving 811 patients were included. The pooled data suggested that there was a significantly higher rate of histologic complete resection and endoscopic complete resection among patients treated with m-EMR than those treated with EMR (histologic complete resection: OR = 0.23, 95 % CI = 0.10–0.51, p < 0.01; endoscopic complete resection: OR = 0.13, 95 % CI = 0.02–0.74, p = 0.02). The procedure time of EMR was longer than m-EMR (MD = 2.40, 95 % CI = 0.33–4.46, p = 0.02). There was a significantly higher rate of vertical margin involvement among patients treated with EMR than those treated with m-EMR; whereas, there was no significant difference of lateral margin involvement between the m-EMR and EMR groups (vertical margin involvement: OR = 5.00, 95 % CI = 2.67–9.33, p < 0.01; lateral margin involvement: OR = 1.44, 95 % CI = 0.48–4.37, p = 0.52). There was no significant difference in mean tumor size among patients treated with m-EMR versus those treated with EMR (MD = −0.30, 95 % CI = −0.75–0.14, p = 0.18); further, there was no significant difference in endoscopic mean sizes of the tumor and pathological mean sizes of the tumor between the m-EMR and EMR groups (endoscopic mean sizes of the tumor: MD = 0.20, 95 % CI = −0.44–0.84, p = 0.43; pathological mean sizes of the tumor: MD = 0.62, 95 % CI = −0.68–1.92, p = 0.05). No significant differences were detected among the treatment groups with regard to complications (bleeding: OR = 0.87, 95 % CI = 0.39–1.95, p = 0.73; complications (bleeding and perforation): OR = 0.87, 95 % CI = 0.40–1.88, p = 0.73). Conclusion The efficacy of m-EMR are better than EMR among patients undergoing endoscopic treatment of rectal neuroendocrine tumors, and the safety of m-EMR is equivalent to EMR treatment.

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