Preliminary Lesion Molding-Aided Endoscopic Mucosal Resection Versus Conventional Endoscopic Mucosal Resection for Nonpedunculated Colorectal Lesions.

BACKGROUND

En bloc and R0 resection of nonpedunculated colonic lesions by conventional endoscopic mucosal resection (EMR) are challenging. Preliminary lesion molding-aided EMR (PM-EMR) is useful for reducing snaring slippage, which may increase successful en bloc and R0 resection rates. Herein, we compared PM-EMR and conventional EMR outcomes.

METHODS

Overall, 112 patients with nonpedunculated colonic lesions measuring 8-15 mm were randomly allocated to either the PM-EMR group or the conventional EMR group. Baseline characteristics and treatment results were analyzed between the groups.

RESULTS

En bloc resection and R0 resection were achieved in the PM-EMR group (100%, 94.6%) and the conventional EMR group (76.8%, 67.9%). For lesions ≥ 10 mm, en bloc and R0 resection rates were greater for PM-EMR than for conventional EMR (100.0% versus 74.4%; 94.4% versus 62.8%, respectively). For lesions with macroscopic morphologies indicating Is/IIa located in the left/right colon, PM-EMR was significantly better than conventional EMR for en bloc resection (100.0% versus 69.2%, 100% versus 76.5%; 100.0% versus 75.0%, 100.0% versus 68.2%, respectively) and R0 resection (100.0% versus 65.4%, 88.9% versus 52.9%; 100.0% versus 60.0%, 90.0% versus 63.6%, respectively).

CONCLUSIONS

PM-EMR is significantly better than conventional EMR regarding en bloc and R0 resection of 10-15 mm nonpedunculated colorectal lesions.