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Endoscopic mucosal resection with precutting vs. anchoring technique using snare tip for 10-25 mm nonpedunculated colorectal polyps: a randomized controlled trial.

Jong Yoon Lee·Hee Yoon Noh·Yang Hyun Baek·Myung Hwan Noh·Minkook Son·Mee Sook Roh·Jong Hoon Lee
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Abstract

BACKGROUND AND AIMS: Modified endoscopic mucosal resection (EMR) techniques using a snare tip, precutting EMR (P-EMR) and anchoring EMR (A-EMR), have been developed for the effective resection of nonpedunculated colorectal polyps measuring 10-25&#x2005;mm. Although previous studies have compared either P-EMR or A-EMR with conventional EMR, no study has directly compared these two snare tip-assisted techniques within modified EMR. This study aimed to evaluate P-EMR and A-EMR in terms of the R0 resection rate and procedure duration. METHODS: This prospective randomized controlled trial enrolled patients with nonpedunculated colorectal polyps measuring 10-25&#x2005;mm. The patients were randomly assigned to the P-EMR or A-EMR groups. The primary outcome was R0 resection rate, defined as en bloc resection with histologically tumor-free margins. Secondary outcomes included the injection-to-snaring time, total procedure time, and adverse events. RESULTS: Each group included 63 polyps, of which 126 were analyzed in the final evaluation. Both groups achieved high R0 resection rates (93.7% for P-EMR and 88.9% for A-EMR), with no significant difference ( P &#x2005;=&#x2005;0.344). However, the A-EMR group demonstrated significantly shorter injection-to-snaring time (181.8&#x2005;&#xb1;&#x2005;81.9 vs. 320.9&#x2005;&#xb1;&#x2005;143.5&#x2005;s, P &#x2005;<&#x2005;0.001) and total procedure time (259.7&#x2005;&#xb1;&#x2005;139.7 vs. 479.8&#x2005;&#xb1;&#x2005;249.0&#x2005;s, P &#x2005;<&#x2005;0.001). Adverse events, including intraprocedural and delayed bleeding, were comparable between the groups. CONCLUSION: Both P-EMR and A-EMR demonstrated high R0 resection rates for nonpedunculated polyps measuring 10-25&#x2005;mm. However, A-EMR achieved these outcomes with a shorter procedure time than P-EMR.

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HumansFemaleEndoscopic Mucosal ResectionMaleProspective StudiesMiddle AgedColonic PolypsTreatment OutcomeAgedOperative TimeColonoscopyAdultTime FactorsTumor BurdenColorectal Neoplasmscolonoscopyendoscopic mucosal resectionpolypectomyJournal ArticleRandomized Controlled TrialComparative StudyResearch Support, Non-U.S. Gov't

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Jong Yoon Lee, Hee Yoon Noh, Yang Hyun Baek, Myung Hwan Noh, Minkook Son, Mee Sook Roh, Jong Hoon Lee. 2026-04-17. Endoscopic mucosal resection with precutting vs. anchoring technique using snare tip for 10-25&#x2009;mm nonpedunculated colorectal polyps: a randomized controlled trial.. https://doi.org/10.1097/meg.0000000000003200

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Journal Article; Randomized Controlled Trial; Comparative Study; Research Support, Non-U.S. Gov't resourceAdult subjectAged subjectColorectal Neoplasms subjectComparative Study subjectFemale subjectHumans subjectJournal Article subjectMale subjectMiddle Aged subjectOperative Time subjectRandomized controlled trials study

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