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Session: ePoster: Other Neoplasia and Endoscopy 7 (Tue8)

EP959 - Underwater Endoscopic Mucosal Resection of Colonic Lesions: Initial Experience in a Chilean hospital

Tuesday, May 13, 2025
8:27 AM – 8:32 AM PT

    ePoster Presenter(s)

  • Felipe Silva

    General Surgery Resident
    Department of Digestive Surgery, Pontificia Universidad Católica de Chile, Chile
    Santiago, Region Metropolitana, Chile

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

    • Author(s)

  • GL

    Gonzalo Latorre, n/a

    Gastroenterologist
    Department of Gastroenterology Pontificia Universidad Católica de Chile, Chile
    Santiago, Region Metropolitana, Chile

    Disclosure information not submitted.

  • PH

    Paola Hunfan, n/a

    Intern
    School of Medicine, Pontificia Universidad Católica de Chile, Chile
    Santiago, Region Metropolitana, Chile

    Disclosure information not submitted.

  • AP

    Antonio Pausin, n/a

    Digestive Surgeon
    Hospital Dr. Humberto Elorza Cortés de Illapel, Coquimbo Health Service, Chile.
    Illapel, Coquimbo, Chile

    Disclosure information not submitted.

  • FB

    Felipe Bellolio, n/a

    Colorectal Surgeon
    Department of Digestive Surgery, Pontificia Universidad Católica de Chile, Chile
    Santiago, Region Metropolitana, Chile

    Disclosure information not submitted.

    • Senior Author(s)

  • AD

    Andrés Donoso, n/a

    Digestive Surgeon
    Department of Digestive Surgery, Pontificia Universidad Católica de Chile, Chile
    Santiago, Region Metropolitana, Chile

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

All of the relevant financial relationships listed below have been mitigated.
Felipe Silva: This individual has no financial relationships with ineligible companies.
Andrés Donoso, n/a: This individual has no financial relationships with ineligible companies.
Image or Table (Do Not add text here):

Purpose/Background: Endoscopic resections have emerged as a minimally invasive option for managing complex colonic lesions. Techniques such as submucosal endoscopic resection present as a complex technique with an associated learning curve. In this context, underwater endoscopic mucosal resections (UEMR) have emerged as secure and less complex alternatives, especially for lesions above 20 mm. The aim of this study is to describe the initial experience with UEMR for colonic epithelial lesions in a tertiary center.

Methods/Interventions: Observational and descriptive study. Patients over 18 years of age who underwent UEMR due to the presence of a colonic epithelial lesion at the Pontificia Universidad Católica de Chile between 2015 and 2024 were included. Demographic, endoscopic, resection protocols, and histopathological variables were collected. Resection was defined as "en bloc" when the lesion was removed in a single complete piece, and recurrence was defined as the reappearance of neoplastic tissue at the resection site during endoscopic follow-up starting at 3 months.

Results/Outcomes: A total of 67 patients were included, with a mean age of 65.1 years (SD ±11.6), and 56.7% (n=38) were women. The median size of the lesions was 26.1 mm (IQR 20-30). En bloc resection was achieved in 41.8% (n=28) of the lesions, with curative resection criteria met in 89.6% (n=60) of the cases. In total, 4 out of the 7 patients who did not meet curative resection criteria required surgical management resulting in an hemicolectomy depending on the sidedness of the lesion. Of the lesions, 22.4% (n=15) were adenocarcinomas (Tis = 8, T1a = 2, T1b = 5), 38.8% (n=26) and 31.3% (n=21) were high-grade and low-grade dysplasias, respectively. No adenocarcinoma or dysplasia were found in 7.5% (n=5) of the cases. Delayed bleeding and bowel perforation were both observed in 1.5% (n=1) cases. No stenosis was observed in this series. The median follow-up of 47.9 months (IQR 22-64), with no perioperative mortality and one cancer-related death observed.

Conclusion/Discussion: UEMR presents as an effective endoscopic technique to treat colonic lesions, presenting as a safe technique with a low rate of complications in this series. Its implementation is feasible in Chile.