Clinical Outcomes of Underwater versus Conventional Endoscopic Mucosal Resection in the Removal of Sessile…

Systematic reviewJournal of gastrointestinal and liver diseases : JGLD· Jul 2026

Clinical Outcomes of Underwater versus Conventional Endoscopic Mucosal Resection in the Removal of Sessile or Flat Colorectal Polyps ≥10 mm: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Yiheng Yao, Jinfeng Chi, Zhihan Wang … Liang Liu

GastroenterologySystematic reviewTreatmentQ2IF 1.3

Underwater EMR improves complete polyp removal compared to conventional EMR.

Clinical Outcomes of Underwater versus Conventional Endoscopic Mucosal Resection in the Removal of Sessile or Flat Colorectal Polyps ≥10 mm: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Yiheng Yao … Liang Liu

Journal of gastrointestinal and liver diseases · Jul 2026 · Q2 in General Medicine

Background

Underwater endoscopic mucosal resection (underwater endoscopic mucosal resection) and conventional endoscopic mucosal resection (conventional endoscopic mucosal resection) are the primary techniques for the removal of colorectal polyps.

Purpose

The purpose of this study is to conduct a meta-analysis on the safety and efficacy of the two procedures, underwater endoscopic mucosal resection and conventional endoscopic mucosal resection.

Methods

We searched multiple databases for randomized controlled trials (randomized controlled trials) comparing underwater endoscopic mucosal resection and conventional endoscopic mucosal resection for the resection of sessile or flat colorectal polyps.

Results

Underwater EMR leads to a higher rate of complete polyp removal

RR by subgroup · 95% CI

More results

Regarding the en bloc resection rate, underwater endoscopic mucosal resection was superior to conventional endoscopic mucosal resection [Risk Ratio (RR) 1.13, 95% confidence interval (CI): 1.02-1.24].

More results

Subgroup analysis showed that the higher en bloc resection rate of underwater endoscopic mucosal resection was mainly manifested in 10-20 mm polyps (RR=1.16, 95%CI: 1.07-1.25).

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Conclusion

For sessile or flat colorectal polyps measuring ≥10 mm in diameter, underwater endoscopic mucosal resection demonstrates superior efficacy compared with conventional endoscopic mucosal resection.

Clinical Outcomes of Underwater versus Conventional Endoscopic Mucosal Resection in the Removal of Sessile or Flat Colorectal Polyps ≥10 mm: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Clinical Outcomes of Underwater versus Conventional Endoscopic Mucosal Resection in the Removal of Sessile or Flat Colorectal Polyps ≥10 mm: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

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