Endoscopy 2019; 51(04): S220
DOI: 10.1055/s-0039-1681828
ESGE Days 2019 ePosters
Friday, April 5, 2019 09:00 – 17:00: Colon and rectum ePosters
Georg Thieme Verlag KG Stuttgart · New York

COMPARISON OF THE THERMAL ARTEFACT BETWEEN EMR AND UNDERWATER-EMR AND IT'S INFLUENCE IN THE HISTOLOGICAL ASSESSMENT

M Sánchez Alonso
1   Endoscopy Unit. Gastroenterology Department, Hospital General Ciudad Real, Ciudad Real, Spain
,
L González López
2   Pathology Department, Hospital General Ciudad Real, Ciudad Real, Spain
,
M Cuatrecasas
3   Pathology Department, Hospital Clinic de Barcelona, Barcelona, Spain
,
J Rodríguez Sánchez
1   Endoscopy Unit. Gastroenterology Department, Hospital General Ciudad Real, Ciudad Real, Spain
› Author Affiliations
Further Information

Publication History

Publication Date:
18 March 2019 (online)

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Aims:

Thermal artefact in endoscopic mucosal resection (EMR) specimens, suppose one of the main drawbacks in the pathologic assessment. Heat dissipation effect endorsed by underwater-EMR might lead a way to prevent this handicap. We aimed to compare the thermal artefact in samples of en-bloc resection perfomed by EMR and Underwater EMR. In this regard, injuries in margins and in the whole samples were cautious assessed.

Methods:

We performed a retrospective cross sectional study in which en bloc specimens of U-EMR and EMR were included. All the procedures were accomplished with Endocut Q current (Effect 3; Time 1-interval 6) (ERBE VIO200 s). All samples were assessed by two expert pathologists according to a non-validated score from 0 (non injury) to 3 (Severe injury-non evaluable) both in margins and the whole sample. Furthermore, we also assess the posibility of been able to mount the pieces in a cork afterward of the resection.

Results:

A total of 40 specimens were finally included (22 U-EMR y 18 EMR). Regarding to the margins assessment, EMR showed a severe injury in 55.6% vs. 27.3% of the lesions resected by U-EMR (p = 0.06). Otherwise, whole architecture of the polyps were deeply altered in 17% of the specimens in the EMR group versus 9% in the U-EMR group (p = 0.47). Nevertheless, these differences were specifically stressed in case of the architecture of serrated lesions, which was severely altered in 100% of cases resected by EMR, compared to only 20% of cases resected by U-EMR (p = 0.07).

Conclusions:

These preliminary results show that U-EMR might be an option to prevent thermal artefact in specimens sent to pathologist. This fact remains especially useful in case of serrated lesions.