Underwater polypectomy without submucosal injection for colorectal lesions ≤ 20 mm in size—a multicenter retrospective observational study

A. W. Yen, A. Amato, S. Cadoni, S. Friedland, Y. H. Hsieh, Joseph Leung, M. Liggi, J. Sul, F. W. Leung

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Background: Underwater polypectomy (UWP) of large (≥ 20 mm) colorectal lesions is well described, but reports of UWP for lesions ≤ 20 mm in size, which account for > 95% of polyps encountered in routine clinical practice, are limited. We assessed the feasibility of UWP in routine practice across various sites for colorectal lesions ≤ 20 mm in size. Methods: A multicenter retrospective study was performed on pooled data from nine colonoscopists at 3 U.S., 1 Taiwanese and 2 Italian sites. Outcomes related to UWP on lesions ≤ 20 mm in size were analyzed. Results: In 117 patients, UWP netted 169 lesions. Polypectomy by hot (HSP, 54%) or cold (CSP, 41%) snare, and cold forceps (CFP, 5%) were performed successfully without endoscopic evidence of residual neoplasia or immediate clinically significant adverse events. The majority (74.6%) were tubular adenomas; 60.9% were from the proximal colon. Histopathologic margins were positive in 4 and unavailable in 26 CSP and 24 HSP specimens. The remainder had negative resection margins on pathologic reports. Conclusion: UWP for colorectal lesions ≤ 20 mm in routine practice across multiple sites confirms the feasibility and acceptability of this technique. Improvement of resection outcomes by UWP in routine practice deserves further evaluation in a randomized controlled trial.

Original languageEnglish (US)
JournalSurgical Endoscopy
DOIs
StateAccepted/In press - Jan 1 2018

Fingerprint

Observational Studies
Retrospective Studies
Injections
Polyps
Surgical Instruments
Adenoma
Multicenter Studies
Colon
Randomized Controlled Trials
Neoplasms
Margins of Excision

Keywords

  • Polypectomy
  • Underwater
  • Water exchange colonoscopy

ASJC Scopus subject areas

  • Surgery

Cite this

Underwater polypectomy without submucosal injection for colorectal lesions ≤ 20 mm in size—a multicenter retrospective observational study. / Yen, A. W.; Amato, A.; Cadoni, S.; Friedland, S.; Hsieh, Y. H.; Leung, Joseph; Liggi, M.; Sul, J.; Leung, F. W.

In: Surgical Endoscopy, 01.01.2018.

Research output: Contribution to journalArticle

Yen, A. W. ; Amato, A. ; Cadoni, S. ; Friedland, S. ; Hsieh, Y. H. ; Leung, Joseph ; Liggi, M. ; Sul, J. ; Leung, F. W. / Underwater polypectomy without submucosal injection for colorectal lesions ≤ 20 mm in size—a multicenter retrospective observational study. In: Surgical Endoscopy. 2018.
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AU - Friedland, S.

AU - Hsieh, Y. H.

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AU - Sul, J.

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