Colon to Rectum

Gastrointest Endosc. 2023;97(5):941–51.e2

Rodríguez Sánchez J, Alvarez-Gonzalez MA, Pellisé M, Coto-Ugarte D, Uchima H, Aranda-Hernández J, Santiago García J, Marín-Gabriel JC, Riu Pons F, Nogales O, Carreño Macian R, Herreros-de-Tejada A, Hernández L, Patrón GO, Rodriguez-Tellez M, Redondo-Cerezo E, Sánchez Alonso M, Daca M, Valdivielso-Cortazar E, Álvarez Delgado A, Enguita M, Montori S, Albéniz E

Underwater versus conventional EMR of large non-pedunculated colorectal lesions: A multicenter randomized controlled trial

Background and aims: Underwater endoscopic mucosal resection (UEMR) is an alternative procedure to conventional endoscopic mucosal resection (CEMR) to treat large non-pedunculated colorectal polyps (LNPCL). In this multicenter randomized clinical trial, the authors aimed to compare the efficacy and safety of UEMR versus CEMR on LNPCL.
Methods: They conducted a multicenter randomized controlled clinical trial from February 2018 to February 2020 in 11 hospitals in Spain. A total of 298 patients (311 lesions) were randomized to the UEMR (n = 149) and CEMR (n = 162) groups. The main outcome was the lesion recurrence rate in at least 1 follow-up colonoscopy. Secondary outcomes included technical aspects, en bloc resection rate, R0 and adverse events, among others.
Results: There were no differences in the overall recurrence rate (9.5% UEMR vs. 11.7% CEMR; absolute risk difference [ARD], -2.2% [95% confidence interval {CI}: -9.4–4.9%]). However, considering the polyp sizes between 20 and 30 mm, the recurrence rate was lower for UEMR (3.4% UEMR vs. 13.1% CEMR; ARD, -9.7% [95% CI: -19.4–0%)]. The R0 resection showed the same tendency, with significant differences favoring UEMR only for polyps between 20 and 30 mm. Overall, UEMR was faster and easier to perform than CEMR. Importantly, both techniques were equally safe.

Conclusions: Underwater endoscopic mucosal resection is a valid alternative to conventional endoscopic mucosal resection of large non-pedunculated colorectal polyps and could be considered the first option of treatment for lesions between 20–30 mm due to its higher en bloc and R0 resection rates.

Dr. Dr. J. Rodríguez Sánchez, Endoscopy Unit, Hospital Universitario 12 de Octubre, Madrid, Spain,
E-Mail: joakinrodriguez@gmail.com

and

Dr. Dr. E. Albéniz, Gastroenterology Department, Endoscopy Unit, Hospital Universitario de Navarra, Pamplona, Navarra, Spain,
E-Mail: edualbeniz@hotmail.com

DOI: DOI: 10.1016/j.gie.2022.12.013

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Early management of acute severe UC in the biologics era: Development and international validation of a prognostic clinical index to predict steroid response

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Post-COVID-19 irritable bowel syndrome

Gut. 2023;72(3):484–92

Marasco G, Cremon C, Barbaro MR, Cacciari G, Falangone F, Kagramanova A, Bordin D, Drug V, Miftode E, Fusaroli P, Mohamed SY, Ricci C, Bellini M, Rahman MM, Melcarne L, Santos J, Lobo B, Bor S, Yapali S, Akyol D, Sapmaz FP, Urun YY, Eskazan T, Celebi A, Kacmaz H, Ebik B, Binicier HC, Bugdayci MS, Yağcı MB, Pullukcu H, Kaya BY, Tureyen A, Hatemi İ, Koc ES, Sirin G, Calıskan AR, Bengi G, Alıs EE, Lukic S, Trajkovska M, Hod K, Dumitrascu D, Pietrangelo A, Corradini E, Simren M, Sjölund J, Tornkvist N, Ghoshal UC, Kolokolnikova O, Colecchia A, Serra J, Maconi G, De Giorgio R, Danese S, Portincasa P, Di Sabatino A, Maggio M, Philippou E, Lee YY, Salvi D, Venturi A, Borghi C, Zoli M, Gionchetti P, Viale P, Stanghellini V, Barbara G; GI-COVID19 study group

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