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. 2023 Mar 6;13(3):711.
doi: 10.3390/life13030711.

Efficacy and Safety of Gel Immersion Endoscopic Mucosal Resection for Non-Pedunculated Colorectal Polyps

Hiroshi Ashizawa  1 , Kinichi Hotta  1 , Kenichiro Imai  1 , Sayo Ito  1 , Yoshihiro Kishida  1 , Kazunori Takada  1 , Taishi Okumura  1 , Noboru Kawata  1 , Masao Yoshida  1 , Yuki Maeda  1 , Yoichi Yamamoto  1 , Tatsunori Minamide  1 , Junya Sato  1 , Hirotoshi Ishiwatari  1 , Hiroyuki Matsubayashi  1 , Hiroyuki Ono  1
Affiliations

Efficacy and Safety of Gel Immersion Endoscopic Mucosal Resection for Non-Pedunculated Colorectal Polyps

Hiroshi Ashizawa et al. Life (Basel). .

Abstract

Underwater endoscopic mucosal resection (UEMR) has become a popular endoscopic resection method for large colorectal neoplasms. However, visualization can be poor during UEMR due to the presence of intestinal fluid. Gel immersion endoscopic mucosal resection (GIEMR), using a specially developed gel (Viscoclear®, Otsuka Pharmaceutical Factory, Tokushima, Japan), can improve the visual field. However, reports of GIEMR for colorectal polyps are limited. Herein, we evaluated the short-term outcomes of GIEMR for non-pedunculated colorectal neoplasms (NPCRN). This single-center, retrospective, and observational study includes 25 lesions in 20 patients with NPCRN who underwent GIEMR between January and October 2022. The short-term outcomes and adverse events were evaluated. The lesion locations were as follows: right colon, 18 lesions; left colon, 7 lesions; and rectum, none. The median tumor diameter was 15 (IQR, 10-18) mm. Histological classification was as follows: sessile serrated lesion, 9 cases; adenoma, 12 cases; and intramucosal adenocarcinoma, 4 cases. The overall en bloc resection rates and R0 resection rates were 80% (20/25) and 72% (18/25). For NPCRN in 10-19 mm, the en bloc resection rate was 75% (12/16), with an R0 resection rate of 69% (11/16). No post-polypectomy bleeding, perforation, or post-coagulation syndrome were observed. The findings of our study provide preliminary evidence of the efficacy and safety of GIEMR for NPCRN. Therefore, GIEMR may be a promising novel endoscopic resection method for NPCRN.

Keywords: colorectal cancer; gel immersion endoscopic mucosal resection; non-pedunculated colorectal neoplasms.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
(a) White light endoscopy showing a 13 mm flat elevated lesion in the ascending colon. (b) Narrow-band imaging (NBI) shows that the lesion is white in color, with no micro-vessels observed. The lesion was diagnosed as a sessile serrated lesion (SSL). (c) Immediately after gel immersion, the lesion was first slightly turbid. (d) Following further immersion gel, a clear visual field was quickly obtained. (e) With a clear visual field, snaring was possible, with confirmation of the tumor margin. (f) The lesion was resected en bloc, without residual; the wound after resection is shown.
See this image and copyright information in PMC

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