Clinicopathological evaluation of the efficacy of endoscopic treatment for sessile serrated lesions comparing endoscopic mucosal resection, cold snare polypectomy, and underwater endoscopic mucosal resection
2025

Evaluating Endoscopic Treatments for Sessile Serrated Lesions

Sample size: 92 publication Evidence: moderate

Author Information

Author(s): Kagemoto Kaizo, Okamoto Koichi, Okada Yasuyuki, sei Motoko, Fujimoto Shota, Yagi Mai, Mitsuhashi Takeshi, Ueda Hiroyuki, Yoshimoto Takanori, Kashihara Takanori, Kawaguchi Tomoyuki, Kida Yoshifumi, Mitsui Yasuhiro, Kawano Yutaka, Sogabe Masahiro, Miyamoto Hiroshi, Sato Yasushi, Muguruma Naoki, Takayama Tetsuji

Primary Institution: Tokushima University Graduate School

Hypothesis

What is the most suitable endoscopic treatment for sessile serrated lesions (SSL)?

Conclusion

Underwater endoscopic mucosal resection (UEMR) is a suitable treatment option for sessile serrated lesions, while cold snare polypectomy (CSP) results were pathologically insufficient.

Supporting Evidence

  • The R0 resection rate was 87% for UEMR, 73% for EMR, and 42% for CSP.
  • CSP specimens often contained no submucosal tissue, leading to inadequate resection depth.
  • All four SSLD cases received R0 resection by EMR and UEMR.

Takeaway

Doctors are trying to find the best way to remove certain types of growths in the colon. They found that one method works better than others.

Methodology

This was a retrospective study analyzing 92 sessile serrated lesions resected by EMR, CSP, and UEMR, focusing on R0 resection rates and submucosal tissue thickness.

Potential Biases

Selection bias due to the exclusion of fragmented or unstretched lesions.

Limitations

The study was conducted at a single center with a small sample size and retrospective design, which may introduce selection bias.

Participant Demographics

The study included 92 patients with a median age of 65 years, with no significant differences in age, gender, or lesion location among treatment groups.

Statistical Information

P-Value

0.001

Statistical Significance

p<0.001

Digital Object Identifier (DOI)

10.1002/deo2.70051

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