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Background <p>Colorectal polyps is considered one of the most prevalent diseases in gastroenterology, this importance stems from its potential risk of malignancy, so early detection and good treatment is crucial. Recently, endoscopic resection has evolved to be the best modality for management, with conventional endoscopic polypectomy as the modality of choice, but there is also a new technique of underwater polyp removal, which is an alternative for management of colorectal polyps.</p> <p>Our objective is to study the efficacy of underwater polypectomy comparative to conventional methods, side effects, and procedure time of each other.</p> <p>This study included 210 case of adults above 18years, having symptoms of colonic affection like anemia, abdominal pain, constipation,105 cases done with conventional methods and 105 cases done with underwater technique, for colorectal polyps’ size<i>(5-40 mm).</i></p> Results <p>The study revealed high statistically significant (<i>p</i>-value &lt; 0.001) decreased operative time in patients of underwater polypectomy <i>(mean = 8.0 minutes ± 0.73, range = 6.4–9.3)</i> when compared to patients of the conventional polypectomy <i>(mean = 14.1 ± 0.98, range = 12.3–16.2).</i></p> <p>There was no statistically significant difference (<i>p</i>-value = 0.391) between studied groups (underwater and conventional polypectomy) as regard En block resection. There were 69 patients (66%) with En block resection in patients of underwater polypectomy group versus 63 patients (60%) in patients of conventional polypectomy group.</p> <p>There was no statistically significant difference between studied groups (underwater and conventional polypectomy) regarding post-operative complications (perforation and post-polypectomy syndrome).</p> Conclusion <p>UEMR is a new technique of underwater polyp removal, which is an alternative for management of colorectal polyps. It can spare ESD in some polyps 2-3 cm in diameter as it allows en block removal. UEMR is superior to CEMR regarding procedure time but there was no difference regarding En block resection or post-operative complications, so it can replace conventional polypectomy. Furthur studies required to improve the technique as well as to improve the results of resection.</p>

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Underwater polypectomy of colonic polyps versus conventional endoscopic mucosal resection, comparative prospective study

  • 期刊论文

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  • 发表日期：

    2025年6月25日

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  • Mohamed El-Ghobary,
  • Wael Aref,
  • Mahmoud Shaaban,
  • Mahmoud Wahba

摘要

Background

Colorectal polyps is considered one of the most prevalent diseases in gastroenterology, this importance stems from its potential risk of malignancy, so early detection and good treatment is crucial. Recently, endoscopic resection has evolved to be the best modality for management, with conventional endoscopic polypectomy as the modality of choice, but there is also a new technique of underwater polyp removal, which is an alternative for management of colorectal polyps.

Our objective is to study the efficacy of underwater polypectomy comparative to conventional methods, side effects, and procedure time of each other.

This study included 210 case of adults above 18years, having symptoms of colonic affection like anemia, abdominal pain, constipation,105 cases done with conventional methods and 105 cases done with underwater technique, for colorectal polyps’ size(5-40 mm).

Results

The study revealed high statistically significant (p-value < 0.001) decreased operative time in patients of underwater polypectomy (mean = 8.0 minutes ± 0.73, range = 6.4–9.3) when compared to patients of the conventional polypectomy (mean = 14.1 ± 0.98, range = 12.3–16.2).

There was no statistically significant difference (p-value = 0.391) between studied groups (underwater and conventional polypectomy) as regard En block resection. There were 69 patients (66%) with En block resection in patients of underwater polypectomy group versus 63 patients (60%) in patients of conventional polypectomy group.

There was no statistically significant difference between studied groups (underwater and conventional polypectomy) regarding post-operative complications (perforation and post-polypectomy syndrome).

Conclusion

UEMR is a new technique of underwater polyp removal, which is an alternative for management of colorectal polyps. It can spare ESD in some polyps 2-3 cm in diameter as it allows en block removal. UEMR is superior to CEMR regarding procedure time but there was no difference regarding En block resection or post-operative complications, so it can replace conventional polypectomy. Furthur studies required to improve the technique as well as to improve the results of resection.