Endoscopy 2019; 51(04): S169
DOI: 10.1055/s-0039-1681669
ESGE Days 2019 ePoster podium presentations
Saturday, April 6, 2019 10:30 – 11:00: Colon: resection 7 ePoster Podium 2
Georg Thieme Verlag KG Stuttgart · New York

UNDERWATER ENDOSCOPIC MUCOSAL RESECTION – A PROSPECTIVE COHORT STUDY

J Fernandes
1   Gastroenterology, Centro Hospitalar Cova da Beira, Covilhã, Portugal
2   Gastroenterology, Hospital de Santa Luzia, Viana do Castelo, Portugal
,
T Araújo
2   Gastroenterology, Hospital de Santa Luzia, Viana do Castelo, Portugal
,
R Ramos
1   Gastroenterology, Centro Hospitalar Cova da Beira, Covilhã, Portugal
,
C Vicente
1   Gastroenterology, Centro Hospitalar Cova da Beira, Covilhã, Portugal
,
J Tristan
1   Gastroenterology, Centro Hospitalar Cova da Beira, Covilhã, Portugal
,
F Lucas
3   Serviço de Medicina do Hospital de Cascais, Cascais, Portugal
,
J Canena
4   Gastroenterology, Nova Medical School/FCML da UNL, Lisbon, Portugal
,
L Lopes
2   Gastroenterology, Hospital de Santa Luzia, Viana do Castelo, Portugal
5   Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
6   ICVS/3B's – PT Government Associate Laboratory, Braga/Guimarães, Portugal
,
C Casteleiro
1   Gastroenterology, Centro Hospitalar Cova da Beira, Covilhã, Portugal
› Author Affiliations
Further Information

Publication History

Publication Date:
18 March 2019 (online)

Also available at
 
 

    Aims:

    Underwater endoscopic mucosal resection (uEMR) is a recent endoscopic technique in which water (exclusively) is instilled in the colon lumen, causing its distension. There is a submucosal floating effect and the muscularis propria stays away because of its greater density, which precludes the need for injection. With this study we intend to evaluate the efficacy and safety of uEMR in the resection of colonic lesions.

    Methods:

    This was a prospective study of 2 centers, between August 2016 and October 2017, including consecutive patients with colonic lesions referred for EMR. All the lesions were exclusively removed by uEMR. Patients underwent colonoscopy 4 – 6 months post uEMR. The main outcomes were technical success, complications and recurrence at short-term follow-up.

    Results:

    32 patients, mean age = 71.90 (SD ± 9.72), 56.25% male (n = 18). 40 lesions were resected, mean size = 29.65 mm (min 10, max 70) of which 35% were located in the ascending colon and 22.5% in the rectum. The lesions were of type 0-IIa in 72.5% (n = 29) and the remainder of type 0-IIa+Is. uEMR was en-bloc in 14 lesions and piecemeal in the others. The technical success was 92.5% (n = 37). The mean duration of UEMR = 22.7 minutes (min 5, max 130). Histopathology showed 40% (n = 16) of lesions with high grade dysplasia, 7.5% (n = 3) with intramucosal adenocarcinoma foci and 1 patient with a focus of invasive adenocarcinoma. Five haemorrhages occurred during UEMR, all treated endoscopically; no other adverse events occurred. In the endoscopic review of the 37 resected lesions 1 patient presented recurrence, which was managed successfully by endoscopy.

    Conclusions:

    EMR has been shown to be safe, easy to perform and effective in removing colonic lesions, and has a low rate of recurrence. This technique may be an alternative to conventional EMR, and randomized studies comparing the two techniques are needed.


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