Endoscopy 2020; 52(S 01): S5-S6
DOI: 10.1055/s-0040-1704025
ESGE Days 2020 oral presentations
Thursday, April 23, 2020 08:30 – 10:00 Large colonic polyps: Slice and dice Ecocem Room
© Georg Thieme Verlag KG Stuttgart · New York

LONG-TERM OUTCOMES AFTER UNDERWATER ENDOSCOPIC MUCOSAL RESECTION VERSUS ENDOSCOPIC SUBMUCOSAL DISSECTION FOR 20-30 MM SIZED COLORECTAL LESIONS: A PROPENSITY SCORE-MATCHED STUDY

T Inoue
1   Osaka International Cancer Institute, Department of Gastrointestinal Oncology, Osaka, Japan,
,
K Nakagawa
1   Osaka International Cancer Institute, Department of Gastrointestinal Oncology, Osaka, Japan,
,
Y Yamasaki
2   Okayama University Hospital, Department of Gastroenterology, Okayama, Japan
,
S Shichijo
1   Osaka International Cancer Institute, Department of Gastrointestinal Oncology, Osaka, Japan,
,
N Uedo
1   Osaka International Cancer Institute, Department of Gastrointestinal Oncology, Osaka, Japan,
,
R Ishihara
1   Osaka International Cancer Institute, Department of Gastrointestinal Oncology, Osaka, Japan,
,
Y Takeuchi
1   Osaka International Cancer Institute, Department of Gastrointestinal Oncology, Osaka, Japan,
› Author Affiliations
Further Information

Publication History

Publication Date:
23 April 2020 (online)

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    Aims Endoscopic submucosal dissection (ESD) has been widely performed for large colorectal polyps in Japan. On the other hand, underwater endoscopic mucosal resection (UEMR) can be an alternative promising endoscopic resection (ER) method for large colorectal lesions. However, there is no direct comparison between ESD and UEMR for large colorectal lesion. In this study, we aimed to evaluate the efficiency of UEMR for 20-30 mm sized colorectal lesions, compared with ESD.

    Methods This was a single-center retrospective observational study. Patients who underwent ER for 20-30 mm sized sessile colorectal lesions at our institution were enrolled. Data were systematically retrieved using endoscopic database and medical charts from November 2014 to February 2019. The main outcome measurement was incidence of local recurrence, which is defined as a lesion that was accompanied with post-ER scar endoscopically and proved pathologically. We performed propensity score matching (PSM) to control and reduce the selection bias between the UEMR and ESD groups. Therapeutic and long-term outcomes were evaluated between the groups.

    Results 76 UEMR and 185 ESD were performed for sessile 20-30 mm sized lesions during the study period. After PSM of the two groups, 59 lesions in each group were compared, and their demographic and tumor characteristics were similar. Median procedure time with UEMR was significantly shorter than that with ESD (6 min vs 57 min, p< 0.001). En bloc resection rate with UEMR was significantly lower than that with ESD (61.0% vs 98.3%, p< 0.001). During median follow-up period of 11 and 13 months for UEMR and ESD, there was no significant difference in local recurrences rate between UEMR and ESD (0% versus 0%, p=1.00).

    Conclusions UEMR for 20-30 mm sized colorectal lesions can be comparable to ESD in terms of long-term outcomes with shorter procedure time, regardless of lower en bloc resection rate.


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