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Underwater versus conventional endoscopic mucosal resection for small size non-pedunculated colorectal polyps: a randomized controlled trial: (UEMR vs. CEMR for small size non-pedunculated colorectal polyps)

BACKGROUND: Underwater endoscopic mucosal resection (UEMR) is a recently developed technique and can be performed during water-aided or ordinary colonoscopy for the treatment of colorectal polyps. The objective of this clinical trial was to evaluate the efficacy and safety of UEMR in comparison with...

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Autores principales: Zhang, Zhixin, Xia, Yonghong, Cui, Hongyao, Yuan, Xin, Wang, Chunnian, Xie, Jiarong, Tong, Yarong, Wang, Weihong, Xu, Lei
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7510164/
https://www.ncbi.nlm.nih.gov/pubmed/32967616
http://dx.doi.org/10.1186/s12876-020-01457-y
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author Zhang, Zhixin
Xia, Yonghong
Cui, Hongyao
Yuan, Xin
Wang, Chunnian
Xie, Jiarong
Tong, Yarong
Wang, Weihong
Xu, Lei
author_facet Zhang, Zhixin
Xia, Yonghong
Cui, Hongyao
Yuan, Xin
Wang, Chunnian
Xie, Jiarong
Tong, Yarong
Wang, Weihong
Xu, Lei
author_sort Zhang, Zhixin
collection PubMed
description BACKGROUND: Underwater endoscopic mucosal resection (UEMR) is a recently developed technique and can be performed during water-aided or ordinary colonoscopy for the treatment of colorectal polyps. The objective of this clinical trial was to evaluate the efficacy and safety of UEMR in comparison with conventional endoscopic mucosal resection (CEMR) of small non-pedunculated colorectal polyps. METHODS: Patients with small size, non-pedunculated colorectal polyps (4–9 mm in size) who underwent colonoscopic polypectomy were enrolled in this multicenter randomized controlled clinical trial. The patients were randomly allocated to two groups, an UEMR group and a CEMR group. Efficacy and safety were compared between groups. RESULTS: In the intention-to-treat (ITT) analysis, the complete resection rate was 83.1% (59/71) in the UEMR group and 87.3% (62/71) in the CEMR group. The en-bloc resection rate was 94.4% (67/71) in the UEMR group and 91.5% (65/71) in the CEMR group (difference 2.9%; 90% CI − 4.2 to 9.9%), showed noninferiority (noninferiority margin − 5.7% < − 4.2%). No significant difference in procedure time (81 s vs. 72 s, P = 0.183) was observed. Early bleeding was observed in 1.4% of patients in the CEMR group (1/71) and 1.4% of patients in the UEMR group (1/71). None of the patients in the UEMR group complained of postprocedural bloody stool, whereas two patients in the CEMR group (2/64) reported this adverse event. CONCLUSION: Our results indicate that UEMR is safer and just as effective as CEMR in En-bloc resection for the treatment of small colorectal polyps as such, UEMR is recommended as an alternative approach to excising small and non-pedunculated colorectal adenomatous polyps. TRIAL REGISTRATION: Clinical Trials.gov, NCT03833492. Retrospectively registered on February 7, 2019.
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spelling pubmed-75101642020-09-25 Underwater versus conventional endoscopic mucosal resection for small size non-pedunculated colorectal polyps: a randomized controlled trial: (UEMR vs. CEMR for small size non-pedunculated colorectal polyps) Zhang, Zhixin Xia, Yonghong Cui, Hongyao Yuan, Xin Wang, Chunnian Xie, Jiarong Tong, Yarong Wang, Weihong Xu, Lei BMC Gastroenterol Research Article BACKGROUND: Underwater endoscopic mucosal resection (UEMR) is a recently developed technique and can be performed during water-aided or ordinary colonoscopy for the treatment of colorectal polyps. The objective of this clinical trial was to evaluate the efficacy and safety of UEMR in comparison with conventional endoscopic mucosal resection (CEMR) of small non-pedunculated colorectal polyps. METHODS: Patients with small size, non-pedunculated colorectal polyps (4–9 mm in size) who underwent colonoscopic polypectomy were enrolled in this multicenter randomized controlled clinical trial. The patients were randomly allocated to two groups, an UEMR group and a CEMR group. Efficacy and safety were compared between groups. RESULTS: In the intention-to-treat (ITT) analysis, the complete resection rate was 83.1% (59/71) in the UEMR group and 87.3% (62/71) in the CEMR group. The en-bloc resection rate was 94.4% (67/71) in the UEMR group and 91.5% (65/71) in the CEMR group (difference 2.9%; 90% CI − 4.2 to 9.9%), showed noninferiority (noninferiority margin − 5.7% < − 4.2%). No significant difference in procedure time (81 s vs. 72 s, P = 0.183) was observed. Early bleeding was observed in 1.4% of patients in the CEMR group (1/71) and 1.4% of patients in the UEMR group (1/71). None of the patients in the UEMR group complained of postprocedural bloody stool, whereas two patients in the CEMR group (2/64) reported this adverse event. CONCLUSION: Our results indicate that UEMR is safer and just as effective as CEMR in En-bloc resection for the treatment of small colorectal polyps as such, UEMR is recommended as an alternative approach to excising small and non-pedunculated colorectal adenomatous polyps. TRIAL REGISTRATION: Clinical Trials.gov, NCT03833492. Retrospectively registered on February 7, 2019. BioMed Central 2020-09-23 /pmc/articles/PMC7510164/ /pubmed/32967616 http://dx.doi.org/10.1186/s12876-020-01457-y Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research Article
Zhang, Zhixin
Xia, Yonghong
Cui, Hongyao
Yuan, Xin
Wang, Chunnian
Xie, Jiarong
Tong, Yarong
Wang, Weihong
Xu, Lei
Underwater versus conventional endoscopic mucosal resection for small size non-pedunculated colorectal polyps: a randomized controlled trial: (UEMR vs. CEMR for small size non-pedunculated colorectal polyps)
title Underwater versus conventional endoscopic mucosal resection for small size non-pedunculated colorectal polyps: a randomized controlled trial: (UEMR vs. CEMR for small size non-pedunculated colorectal polyps)
title_full Underwater versus conventional endoscopic mucosal resection for small size non-pedunculated colorectal polyps: a randomized controlled trial: (UEMR vs. CEMR for small size non-pedunculated colorectal polyps)
title_fullStr Underwater versus conventional endoscopic mucosal resection for small size non-pedunculated colorectal polyps: a randomized controlled trial: (UEMR vs. CEMR for small size non-pedunculated colorectal polyps)
title_full_unstemmed Underwater versus conventional endoscopic mucosal resection for small size non-pedunculated colorectal polyps: a randomized controlled trial: (UEMR vs. CEMR for small size non-pedunculated colorectal polyps)
title_short Underwater versus conventional endoscopic mucosal resection for small size non-pedunculated colorectal polyps: a randomized controlled trial: (UEMR vs. CEMR for small size non-pedunculated colorectal polyps)
title_sort underwater versus conventional endoscopic mucosal resection for small size non-pedunculated colorectal polyps: a randomized controlled trial: (uemr vs. cemr for small size non-pedunculated colorectal polyps)
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7510164/
https://www.ncbi.nlm.nih.gov/pubmed/32967616
http://dx.doi.org/10.1186/s12876-020-01457-y
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