Endoscopic mucosal resection with a circumferential incision in the removal of colorectal neoplasms (preliminary results of the prospective randomized study)

Abstract

AIM: to assess the early results in patients with benign epithelial colorectal neoplasms which underwent endoscopic mucosal resection with a circumferential incision (C-EMR).PATIENTS AND METHODS: a prospective randomized trial included 50 patients who underwent endoscopic removal of benign epithelial colorectal neoplasms sized 20–30 mm (November 2020 — January 2022). The main group included 26 patients which underwent C-EMR. The control group included 24 patients which underwent endoscopic submucosal dissection (ESD).RESULTS: postoperative complications developed in the C-EMR group in 5 (19.2%), and in the ESD group — in 7 (29.2%) cases (p = 0.51). The operative time in the C-EMR group was significantly less than in the ESD group — 30 vs 60 min., respectively (p < 0.001). In all cases in both groups, tumors were removed en bloc. There R0 resection were performed in 22 (84.6%) and in 23 (95.8%) cases in the main and control groups, respectively (p = 0.3). Two (8.3%) procedures in the control group were converted to the C-EMR procedure.CONCLUSION: endoscopic mucosal resection with a circumferential incision is an effective and safe method for removing benign epithelial neoplasms sized 20–30 mm, as well as submucosal dissection. The removal of the tumor by the C-EMR method reduces operative time by half compared with ESD method.