title: Endoscopic Mucosal Resection with Circumferential Mucosal Incision for Colorectal Neoplasms: Comparison with Endoscopic Submucosal Dissection and between Two Endoscopists with Different Experiences.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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). Theen blocresection rate was 94.1% in the CMI-EMR group and 100% in the ESD group (p=0.061). There were no differences in theen blocresection and complication rates of CMI-EMRs between a Korean and an American endoscopist.
  
  
  CONCLUSIONS
  For the treatment of moderate-size colorectal lesions, CMI-EMR showed a trend toward loweren blocresection rate, but required shorter procedure time than ESD. CMI-EMR outcomes were similar when performed by a Korean ESD expert and an American ESD novice.
authors.affiliation: Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Dong-Hoon
authors.initials: DH
authors.lastname: Yang
authors.affiliation: Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Min-Seob
authors.initials: MS
authors.lastname: Kwak
authors.affiliation: Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Sang Hyoung
authors.initials: SH
authors.lastname: Park
authors.affiliation: Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Byong Duk
authors.initials: BD
authors.lastname: Ye
authors.affiliation: Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Jeong-Sik
authors.initials: JS
authors.lastname: Byeon
authors.affiliation: Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Seung-Jae
authors.initials: SJ
authors.lastname: Myung
authors.affiliation: Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Suk-Kyun
authors.initials: SK
authors.lastname: Yang
authors.affiliation: Institute for Digestive Research, Soonchunhyang University College of Medicine, Seoul, Korea.
authors.forename: Hyun Gun
authors.initials: HG
authors.lastname: Kim
authors.affiliation: Department of Gastroenterology and Hepatology, Stanford University School of Medicine, Stanford, Department of Gastroenterology, VA Palo Alto Health Care System, Palo Alto, CA, USA.
authors.forename: Shai
authors.initials: S
authors.lastname: Friedland
keywords: Colon; Endoscopic mucosal resection; Endoscopic submucosal dissection; Neoplasms; Rectum