Endoscopy 2020; 52(S 01): S111
DOI: 10.1055/s-0040-1704342
ESGE Days 2020 oral presentations
Saturday, April 25, 2020 08:30 – 10:30 Large colonic polyps: Slice and dice The Liffey B
© Georg Thieme Verlag KG Stuttgart · New York

EFFICACY OF UNDERWATER ENDOSCOPIC MUCOSAL RESECTION FOR THE TREATMENT OF LARGE COMPLEX COLORECTAL LESIONS: A RANDOMIZED AND MULTICENTER CONTROL TRIAL

Spanish Group of Endoscopic Mucosal Resection (Spanish Society of Gastrointestinal Endoscopy)
J Rodríguez Sánchez
1   Hospital Universitario 12 de Octubre, Universidad Complutense de Madrid, Endoscopy Unit, Madrid, Spain
2   Hospital Quiron Salud Ciudad Real, Gastrointestinal Diseases Unit, Ciudad Real, Spain
,
D Coto Ugarte
3   Hospital Universitario de Cruces, Endoscopy Unit, Baracaldo, Spain
,
HIU Koeklin
4   Hospital Josep Trueta, Endoscopy Unit, Gerona, Spain
,
MP Ulquiza
5   Hospital Clínic de Barcelona, Endoscopy Unit, Barcelona, Spain
,
JC Marín Gabriel
1   Hospital Universitario 12 de Octubre, Universidad Complutense de Madrid, Endoscopy Unit, Madrid, Spain
,
J Aranda
6   Hospital Universitario Gregorio Marañon, Endoscopy Unit, Madrid, Spain
,
FR Pons
7   Hospital del Mar, Endoscopy Unit, Barcelona, Spain
,
MA Álvarez González
7   Hospital del Mar, Endoscopy Unit, Barcelona, Spain
,
L Hernández
8   Hospital Santos Reyes, Endoscopy Unit, Aranda de Duero, Spain
,
R Carreño Macian
9   Hospital San Pedro, Endoscopy Unit, Logroño, Spain
,
J Santiago
10   Hospital Puerta de Hierro, Endoscopy Unit, Majadahonda, Spain
,
O Patrón
11   Hospital de Manacor, Endoscopy Unit, Manacor, Spain
,
AH de Tejada
10   Hospital Puerta de Hierro, Endoscopy Unit, Majadahonda, Spain
,
O Nogales
12   Hospital General Universitario Gregorio Marañon, Endoscopy Unit, Madrid, Spain
,
M Rodríguez Téllez
13   Hospital Universitario Virgen Macarena, Endoscopy Unit, Sevilla, Spain
,
E Valdivieso Cortazar
14   Hospital Juan Canalejo, Endoscopy Unit, Coruña, Spain
,
A Álvarez
15   Hospital de Salamanca, Endoscopy Unit, Salamanca, Spain
,
E Albéniz Albizu
16   Hospital de Navarra, Endoscopy Unit, Pamplona, Spain
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Publikationsverlauf

Publikationsdatum:
23. April 2020 (online)

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    Aims The efficacy of U-EMR has been tested in small and médium size colorectal lesions. However there are not comparative studies focussed on assessing its suitability for the treatment of complex colorectal lesions (> 2 cm in size or scared).

    Methods Randomized and multicenter control trial with 14 Spanish centers. Consecutive lesions larger than 2 cm and previously treated lesions were included, which were randomized using the REDCAP platform.

    Results A total of 267 lesions (32.75 mm) were enrolled (141 in CEMR group (16 recurrences) and 126 in the UEMR group (15 recurrences)). There was no difference in technical success (87.2% EMRvs.91.3% UEMR; p 0.19). UEMR showed better results in terms of complete resection rate (82% vs. 90%; p=0.04) with no differences in the en bloq resection rate (20%EMRvs.25%UEMR; p=0.56). Likewise, UEMR procedure was faster than CEMR (30.53vs.20.70 min; p< 0.001). Perception of technical difficulty was similar in both groups (30.6% EMR vs.2 4.8% UEMR; p=0.42). Regarding the rate of adverse events, there was no differences in terms of perforation (2,1% vs. 2,4%; p=0.60). However, the intraprocedural bleeding rate was higher in UEMR group (18%vs.12.7%; p=0.29) with no clinical signficance. However delayed bleeding rate was two-fold higher in CEMR (4% vs. 8%; p=0.14). All complications except one hemorrhage in the CEMR group were resolved endoscopically. A total of 112 procedures (41.9% of the total)

    (57 in CEMR and 55 in UEMR) were reviewed at 3-6 months with a slightly higher percentage of recurrences in the EMR group (17.6% EMR vs. 9.1% EMRU; p=0.33), again without statistically significant differences.

    Conclusions UEMR and EMR showed similar rates of efficacy in the treatment of complex colorectal lesions. However, with UEMR the procedure was more efficient, with a trend to be safer than CEMR and with a lower recurrence rate. NCT03567746


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