CHICAGO—Underwater endoscopic mucosal resection conveys numerous advantages over the conventional approach for resection of colorectal polyps, according to a meta-analysis presented at Digestive Disease Week 2023.
“We found that for all lesions—irrespective of their size—underwater endoscopic mucosal resection outperforms conventional EMR in terms of en bloc resection, R0 resection and rate of polyp recurrence,” said lead investigator Saurabh Chandan, MD, an assistant professor of gastroenterology at Creighton University School of Medicine, in Omaha, Nebraska.
The data are somewhat less clear for lesions larger than 20 mm, he added. “I would say that [underwater] EMR is comparable to [conventional] EMR, and perhaps somewhat more favorable.”
Dr. Chandan and his co-investigators conducted a systematic review and meta-analysis comparing outcomes of the two techniques, assessing data of successful R0, en bloc and piecemeal resections from prospective randomized controlled trials published by November 2022 (abstract Sa1715). With results from seven randomized controlled trials, the meta-analysis included 865 resections performed with underwater EMR and 826 resections with conventional EMR, of which 177 and 192, respectively, involved polyps larger than 20 mm.