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MINERVA GASTROENTEROLOGICA E DIETOLOGICA

A Journal on Gastroenterology, Nutrition and Dietetics


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Minerva Gastroenterologica e Dietologica 2017 Oct 09

DOI: 10.23736/S1121-421X.17.02444-8

Copyright © 2017 EDIZIONI MINERVA MEDICA

language: English

Underwater endoscopic mucosal resection (UEMR): an alternative for removal of large sessile colorectal polyps

Dalbir S. SANDHU 1, 2 , Ye J. LEE 2, Henning GERKE 2

1 Division of Gastroenterology & Hepatology, MetroHealth Medical Center, Case Western Reserve University, Cleveland, OH, USA; 2 Division of Gastroenterology & Hepatology, University of Iowa Hospital & Clinics, Iowa City, IA, USA


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BACKGROUND AND AIMS: Large sessile/flat colonic polyps are traditionally removed by lift polypectomy. Underwater endoscopic mucosal resection (UEMR) is a novel technique where air is suctioned out and replaced by water to decompress the colon so that the flat lesions assumes a more polypoid shape facilitating its removal with the standard snare resection. We report the feasibility and safety in our series of patients utilizing this technique.
PATIENTS AND METHODS: A retrospective, observational study of all patients who underwent removal of large colonic polyps (>10 mm) over a period of 3 years (January 2012 - January 2015) at a tertiary care center by UEMR were included in the study.
RESULTS: A total of 102 polyps were removed in 93 adult patients using UEMR. The mean age of patients was 64.7 ± 9.7. The average number of polyps per patient was 1.84 ± 1.3 with a range of 1-7. The range of the polyp size was 10 mm to 60 mm. The mean size of the polyp was 20.4 ± 9.4 mm, median size 26.9 ± 9.4 mm. 92 (90.2%) were removed in piecemeal fashion and 10 (9.8%) were removed en-bloc. Delayed bleeding occurred in 7 (9.7%) patients.
CONCLUSIONS: In this largest series on UEMR, we report the feasibility and safety of this procedure. Future randomized trials comparing this technique versus standard lift polypectomy technique will further elucidate the benefit of one over other.


KEY WORDS: Underwater EMR - Polypectomy - Colon polyps

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Publication History

Article first published online: October 9, 2017
Manuscript accepted: October 6, 2017
Manuscript received: September 13, 2017

Cite this article as

Sandhu DS, Lee YJ, Gerke H. Underwater endoscopic mucosal resection (UEMR): an alternative for removal of large sessile colorectal polyps. Minerva Gastroenterol Dietol 2017 Oct 09. DOI: 10.23736/S1121-421X.17.02444-8

Corresponding author e-mail

drdalbir@gmail.com