Novel resection technique for large flat colorectal tumors: Clip-line-assisted underwater endoscopic mucosal resection.

Abstract

Underwater endoscopic mucosal resection (U-EMR) enables the resection of large colorectal tumors without local injection [1]. Endoscopic submucosal dissection (ESD) is often used for lesions larger than 20 mm. Historically, the rate of en bloc resection with U-EMR is lower than that with ESD [2]. We have devised clip-line-assisted U-EMR (CLU-EMR) for the resection of large tumors in the duodenum [3]. Herein, we present the successful resection of a large, flat 40-mm colorectal tumor using CLU-EMR.