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Outcomes of Gastrointestinal Polyps Resected Using Underwater Endoscopic Mucosal Resection (UEMR) Compared to Conventional Endoscopic Mucosal Resection (CEMR)

Objective Underwater endoscopic mucosal resection (UEMR) is reported to be superior to conventional endoscopic mucosal resection (CMER) for the complete resection of large polyps and may offer increased procedural efficiency. Aims To compare recurrence rates and adverse events between UEMR and CEMR...

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Autores principales: Mouchli, Mohamad Awf, Reddy, Shravani, Walsh, Chirstopher, Mir, Adil, Bierle, Lindsey, Chitnavis, Vikas, Yeaton, Paul, Shakhatreh, Mohammad
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7735526/
https://www.ncbi.nlm.nih.gov/pubmed/33329981
http://dx.doi.org/10.7759/cureus.11485
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author Mouchli, Mohamad Awf
Reddy, Shravani
Walsh, Chirstopher
Mir, Adil
Bierle, Lindsey
Chitnavis, Vikas
Yeaton, Paul
Shakhatreh, Mohammad
author_facet Mouchli, Mohamad Awf
Reddy, Shravani
Walsh, Chirstopher
Mir, Adil
Bierle, Lindsey
Chitnavis, Vikas
Yeaton, Paul
Shakhatreh, Mohammad
author_sort Mouchli, Mohamad Awf
collection PubMed
description Objective Underwater endoscopic mucosal resection (UEMR) is reported to be superior to conventional endoscopic mucosal resection (CMER) for the complete resection of large polyps and may offer increased procedural efficiency. Aims To compare recurrence rates and adverse events between UEMR and CEMR and define risk factors related to recurrence. Also, to assess recurrence rates in piecemeal endoscopic mucosal resection (EMR) based on the number of pieces resected. Methods We identified all patients with large polyps treated using the UEMR technique at Carilion Clinic, Roanoke, VA, USA between January 1, 2014 and December 31, 2017 with follow-up through October of 2018. We matched the UEMR patients with patients treated using the CEMR technique (1:2 matching, respectively). The Kaplan-Meier curve was used to estimate the cumulative risks of polyp recurrence. The Cox proportional hazard analysis was used to assess risk factors for developing polyp recurrence. Results Sixty-eight patients (mean age: 63.4 ± 12.5 years; 52.9% males) with polyps removed using the UEMR technique (Group 1) were matched with 122 patients (mean age: 64.4 ± 10.0 years; 51.6% males) who had polyps removed using CEMR (Group 2). Polyps resected in fewer pieces (≤ 3) had lower recurrence rates compared to the ones resected in >3 pieces. Right colon polyps removed using UEMR had a lower recurrence rate compared to right colon polyps resected using CEMR. Polyp size and a high degree of dysplasia were associated with a high risk of polyp recurrence after resection. Completing advanced endoscopy training was also associated with a lower risk of recurrence. Conclusion UEMR had a lower recurrence rate compared with CEMR for right colon polyps. Factors associated with recurrence included the degree of training, high-grade dysplasia, and polyp size.
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spelling pubmed-77355262020-12-15 Outcomes of Gastrointestinal Polyps Resected Using Underwater Endoscopic Mucosal Resection (UEMR) Compared to Conventional Endoscopic Mucosal Resection (CEMR) Mouchli, Mohamad Awf Reddy, Shravani Walsh, Chirstopher Mir, Adil Bierle, Lindsey Chitnavis, Vikas Yeaton, Paul Shakhatreh, Mohammad Cureus Gastroenterology Objective Underwater endoscopic mucosal resection (UEMR) is reported to be superior to conventional endoscopic mucosal resection (CMER) for the complete resection of large polyps and may offer increased procedural efficiency. Aims To compare recurrence rates and adverse events between UEMR and CEMR and define risk factors related to recurrence. Also, to assess recurrence rates in piecemeal endoscopic mucosal resection (EMR) based on the number of pieces resected. Methods We identified all patients with large polyps treated using the UEMR technique at Carilion Clinic, Roanoke, VA, USA between January 1, 2014 and December 31, 2017 with follow-up through October of 2018. We matched the UEMR patients with patients treated using the CEMR technique (1:2 matching, respectively). The Kaplan-Meier curve was used to estimate the cumulative risks of polyp recurrence. The Cox proportional hazard analysis was used to assess risk factors for developing polyp recurrence. Results Sixty-eight patients (mean age: 63.4 ± 12.5 years; 52.9% males) with polyps removed using the UEMR technique (Group 1) were matched with 122 patients (mean age: 64.4 ± 10.0 years; 51.6% males) who had polyps removed using CEMR (Group 2). Polyps resected in fewer pieces (≤ 3) had lower recurrence rates compared to the ones resected in >3 pieces. Right colon polyps removed using UEMR had a lower recurrence rate compared to right colon polyps resected using CEMR. Polyp size and a high degree of dysplasia were associated with a high risk of polyp recurrence after resection. Completing advanced endoscopy training was also associated with a lower risk of recurrence. Conclusion UEMR had a lower recurrence rate compared with CEMR for right colon polyps. Factors associated with recurrence included the degree of training, high-grade dysplasia, and polyp size. Cureus 2020-11-14 /pmc/articles/PMC7735526/ /pubmed/33329981 http://dx.doi.org/10.7759/cureus.11485 Text en Copyright © 2020, Mouchli et al. http://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Gastroenterology
Mouchli, Mohamad Awf
Reddy, Shravani
Walsh, Chirstopher
Mir, Adil
Bierle, Lindsey
Chitnavis, Vikas
Yeaton, Paul
Shakhatreh, Mohammad
Outcomes of Gastrointestinal Polyps Resected Using Underwater Endoscopic Mucosal Resection (UEMR) Compared to Conventional Endoscopic Mucosal Resection (CEMR)
title Outcomes of Gastrointestinal Polyps Resected Using Underwater Endoscopic Mucosal Resection (UEMR) Compared to Conventional Endoscopic Mucosal Resection (CEMR)
title_full Outcomes of Gastrointestinal Polyps Resected Using Underwater Endoscopic Mucosal Resection (UEMR) Compared to Conventional Endoscopic Mucosal Resection (CEMR)
title_fullStr Outcomes of Gastrointestinal Polyps Resected Using Underwater Endoscopic Mucosal Resection (UEMR) Compared to Conventional Endoscopic Mucosal Resection (CEMR)
title_full_unstemmed Outcomes of Gastrointestinal Polyps Resected Using Underwater Endoscopic Mucosal Resection (UEMR) Compared to Conventional Endoscopic Mucosal Resection (CEMR)
title_short Outcomes of Gastrointestinal Polyps Resected Using Underwater Endoscopic Mucosal Resection (UEMR) Compared to Conventional Endoscopic Mucosal Resection (CEMR)
title_sort outcomes of gastrointestinal polyps resected using underwater endoscopic mucosal resection (uemr) compared to conventional endoscopic mucosal resection (cemr)
topic Gastroenterology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7735526/
https://www.ncbi.nlm.nih.gov/pubmed/33329981
http://dx.doi.org/10.7759/cureus.11485
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