Randomized Controlled Trial
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Jun 27, 2025; 17(6): 103635
Published online Jun 27, 2025. doi: 10.4240/wjgs.v17.i6.103635
Underwater vs conventional endoscopic mucosal resection for nonpedunculated colorectal neoplasms: A randomized controlled trial
Quang D Le, Nhan Q Le, Duc T Quach
Quang D Le, Duc T Quach, Department of Internal Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City 70000, Viet Nam
Nhan Q Le, Department of Gastrointestinal Endoscopy, University Medical Center at Ho Chi Minh City, Ho Chi Minh City 70000, Viet Nam
Author contributions: Quach DT and Le QD initiated the study, designed the research, supervised the study, performed the statistical analyses, interpreted the data, and wrote and critically revised the manuscript; Le QD and Le NQ contributed to the data acquisition; Le QD submitted the study; All authors approved the final version of the draft.
Institutional review board statement: The Institutional Review Board of the University of Medicine and Pharmacy at Ho Chi Minh City approved the study (No. IRB-VN01002/IORG0008603/FWA00023448).
Clinical trial registration statement: This study is registered at https://clinicaltrials.gov/. The registration identification number is No. NCT05825664.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: The authors have no conflicts of interest to declare.
CONSORT 2010 statement: The authors have read the CONSORT 2010 Statement, and the manuscript was prepared and revised according to the CONSORT 2010 Statement.
Data sharing statement: Technical appendix, statistical code and dataset available from the corresponding author at drquachtd@ump.edu.vn. The participants provided informed consent for data sharing.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Duc T Quach, PhD, Associate Professor, Department of Internal Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Hong Bang Street, Ho Chi Minh City 70000, Viet Nam. drquachtd@ump.edu.vn
Received: November 26, 2024
Revised: March 23, 2025
Accepted: April 21, 2025
Published online: June 27, 2025
Processing time: 185 Days and 20.9 Hours
Core Tip

Core Tip: This randomized controlled trial compared underwater endoscopic mucosal resection (UEMR) and conventional EMR for nonpedunculated colorectal neoplasms (10-30 mm). UEMR demonstrated superior outcomes, including a significantly higher curative resection (R0) rate (98.4% vs 90.3%; P = 0.007), greater en bloc resection (100% vs 94.6%; P = 0.014), shorter procedure time (65 vs 185 seconds; P < 0.001), reduced bleeding risk (1.5% vs 10%; P = 0.003), and fewer hemostatic clips used (2 vs 3; P < 0.001). These findings indicate that UEMR is a safer and more effective technique for managing nonpedunculated colorectal neoplasms.