Underwater endoscopic mucosal resection is superior to conventional endoscopic mucosal resection for medium-sized colorectal sessile polyps: a randomized controlled trial

The comparison of underwater endoscopic mucosal resection (UEMR) and conventional endoscopic mucosal resection (CEMR) in the treatment of medium-sized (10 mm ≤ diameter ≤ 20 mm) colorectal sessile polyps is unknown. This randomized controlled trial (RCT) was designed to compare the efficacy and safety of UEMR and CEMR in the treatment of medium-sized colorectal sessile polyps. 200 patients with medium-sized colorectal sessile polyps were randomly divided into UEMR group and CEMR group equally. The resection rates, patient tolerance and complications of the two groups were evaluated. The R0 resection rate (73.3% vs. 56.3%, P = 0.011) and the En bloc resection rate (91.1% vs. 80.6%, P = 0.032) of the UEMR group were significantly higher than those of the CEMR group; The mean abdominal pain score of the UEMR group was significantly lower than that of the CEMR group [(3.2 ± 1.9) vs. (4.1 ± 2.1), P = 0.006]; There was no significant difference in the intraoperative bleeding rate between the two groups (4.0% vs. 6.1%, P = 0.516). There was no delayed bleeding and perforation in both groups. UEMR was effective in the treatment of medium-sized sessile colorectal polyps with few complications, and patient tolerance was good, which is worthy of clinical promotion.The study was registered at the Chinese Clinical Trial Registry (ChiCTR2400082051) on 19/03/2024 and can be accessed at www.chictr.org.cn .