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Underwater Endoscopic Mucosal Resection for 10 mm or Larger Nonpedunculated Colorectal Polyps: A Systematic Review and Meta-Analysis
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Rajat Garg, Amandeep Singh, Manik Aggarwal, Jaideep Bhalla, Babu P. Mohan, Carol Burke, Tarun Rustagi, Prabhleen Chahal
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Clin Endosc 2021;54(3):379-389. Published online April 29, 2021
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DOI: https://doi.org/10.5946/ce.2020.276
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 Abstract
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- Background
/Aims: Recent studies have reported the favorable outcomes of underwater endoscopic mucosal resection (UEMR) for colorectal polyps. We performed a systematic review and meta-analysis evaluating the efficacy and safety of UEMR for nonpedunculated polyps ≥10 mm.
Methods
We performed a comprehensive search of multiple databases (through May 2020) to identify studies reporting the outcomes of UEMR for ≥10 mm nonpedunculated colorectal polyps. The assessed outcomes were recurrence rate on the first follow-up, en bloc resection, incomplete resection, and adverse events after UEMR.
Results
A total of 1276 polyps from 16 articles were included in our study. The recurrence rate was 7.3% (95% confidence interval [CI], 4.3–12) and 5.9% (95% CI, 3.6–9.4) for nonpedunculated polyps ≥10 and ≥20 mm, respectively. For nonpedunculated polyps ≥10 mm, the en bloc resection, R0 resection, and incomplete resection rates were 57.7% (95% CI, 42.4–71.6), 58.9% (95% CI, 42.4–73.6), and 1.5% (95% CI, 0.8–2.6), respectively. The rates of pooled adverse events, intraprocedural bleeding, and delayed bleeding were 7.0%, 5.4%, and 2.9%, respectively. The rate of perforation and postpolypectomy syndrome was 0.8%.
Conclusions
Our systematic review and meta-analysis demonstrates that UEMR for nonpedunculated colorectal polyps ≥10 mm is safe and effective with a low rate of recurrence.
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Citations
Citations to this article as recorded by  - Polypectomy Techniques for Pedunculated and Nonpedunculated Polyps
Karl Kwok, Sasan Mosadeghi, Daniel Lew
Techniques and Innovations in Gastrointestinal Endoscopy.2023; 25(4): 361. CrossRef - Underwater versus conventional endoscopic mucosal resection for colorectal lesions: a systematic review and meta-analysis of randomized clinical trials
Matheus Henrique Gonçalves de Souza, Paula Arruda do Espirito Santo, Fauze Maluf-Filho, Luciano Lenz
International Journal of Colorectal Disease.2023;[Epub] CrossRef - Endoscopic treatment of colorectal polyps and early colorectal cancer
Yunho Jung
Journal of the Korean Medical Association.2023; 66(11): 642. CrossRef - EMR and ESD: Indications, techniques and results
Mamoon Ur Rashid, Mohammad Alomari, Sadaf Afraz, Tolga Erim
Surgical Oncology.2022; 43: 101742. CrossRef - Safety and effectiveness of underwater cold snare resection without submucosal injection of large non-pedunculated colorectal lesions
Andrew W. Yen, Joseph W. Leung, Malcom Koo, Felix W. Leung
Endoscopy International Open.2022; 10(06): E791. CrossRef - Underwater or conventional endoscopic mucosal resection for intermediate‐sized colorectal neoplasm?
Li‐Chun Chang
Advances in Digestive Medicine.2021; 8(3): 133. CrossRef
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