Efficacy of water pressure method for colorectal endoscopic submucosal dissection: a propensity-score matching analysis

Background and study aim: The technical difficulty of endoscopic submucosal dissection (ESD) for colorectal neoplasms has not been resolved. Water pressure method (WPM) are helpful techniques to overcome colorectal ESD procedure. We evaluated the efficacy and safety of ESD with WPM (WPM-ESD) for colorectal neoplasms compared with conventional ESD (C-ESD). Patients and methods: This was a single-center retrospective observational study. 311 colorectal lesions were allocated into the WPM-ESD and the C-ESD groups, which were compared before and after propensity score matching. The main outcomes were to compare the procedure time, the proportion of R0 resection, and the incidence of adverse events between the two groups. Result: 134 and 177 lesions were allocated to the WPM-ESD and the C-ESD groups, and propensity score matching analysis created 92 matched pairs. The mean procedure time was significantly shorter in the WPM-ESD group (49 ± 26 vs. 58 ± 42 min, p = 0.032). All lesions were resected with one piece, without difference in the proportion of en bloc resection (100% vs. 100%) and R0 resection (92% vs. 96%, p = 0.536) and in incidence of intraoperative perforation (2.2% vs. 2.2%). Conclusion: WPM for colorectal ESD may shorten the procedure time compared with C-ESD without increasing adverse events.

Publication History

Received: 15 August 2024

Accepted after revision: 14 February 2025

Accepted Manuscript online:
21 February 2025