Depth of endoscopic mucosal resection with cold snare under dry and underwater.

Abstract

The objective of this study was to evaluate the depth of endoscopic mucosal resection with a cold snare, both dry and underwater, in patients with non-polypoid colorectal neoplasms. An observational, retrospective study was conducted at the La Trinidad Teaching Medical Center, involving patients over 18 years of age with non-polypoid lesions observed during colonoscopy and resected using a cold snare. The thickness of the submucosa was measured to assess the depth of the cut. A total of 87 polyps in 64 patients aged between 35 and 86 years (mean age 62) were analyzed. The dry technique was the most commonly used (68.97%). In lesions measuring 5-20 mm, both techniques proved effective in achieving complete mucosal resections. 24% of the resections showed submucosa. The average submucosal thickness with the dry technique was 196.43 µm, compared to 166.67 µm with the underwater technique. In terms of histological diagnosis, adenomas predominated in the resected lesions. Endoscopic mucosal resection with a cold snare, both dry and underwater, was effective for treating flat lesions ≤ 20 mm with no suspicion of high-grade dysplasia or submucosal invasion. These findings support the standardization of endoscopic practices, as the use of the cold snare is a safe, simple, low-cost technique that does not require electrocoagulation, reducing the risk of complications.