Endoscopic mucosal resection with circumferential mucosal incision (CMI-EMR) may offer benefits comparable to those of endoscopic submucosal dissection (ESD), while requiring less technical proficiency than ESD.
We retrospectively compared the outcomes of CMI-EMR ( n=34) and size-matched ESD ( n=102), which were performed by a Korean endoscopist for colorectal epithelial lesions of 20–35 mm. Procedural parameters of CMI-EMRs performed by an American ESD novice ( n=30) were compared with those performed by the Korean endoscopist.
The lesion size was 22.3±3.9 mm and 22.9±2.4 mm in the CMI-EMR and size-matched ESD groups, respectively ( p=0.730). The resection time was 12.7±7.0 minutes in the CMI-EMR group and 45.6±30.1 minutes in the ESD group ( p<0.001). The en bloc resection rate was 94.1% in the CMI-EMR group and 100% in the ESD group ( p=0.061). There were no differences in the en bloc resection and complication rates of CMI-EMRs between a Korean and an American endoscopist.