Preliminary Lesion Molding-Aided Endoscopic Mucosal Resection Versus Conventional Endoscopic Mucosal Resection for Nonpedunculated Colorectal Lesions

Qing-Hai Peng; Xiang-Rong Zhou; Zhi-Qiang Du; Shan-Cheng Luo; Hang-Jun He; Fei Wang; Da-Hai Xu; Yue Wang; Jin-Wang; Wei-Hui Liu

doi:10.1177/10926429251414556

Preliminary Lesion Molding-Aided Endoscopic Mucosal Resection Versus Conventional Endoscopic Mucosal Resection for Nonpedunculated Colorectal Lesions

J Laparoendosc Adv Surg Tech A. 2026 Feb 4:10926429251414556. doi: 10.1177/10926429251414556. Online ahead of print.

Authors

Qing-Hai Peng¹, Xiang-Rong Zhou¹, Zhi-Qiang Du¹, Shan-Cheng Luo², Hang-Jun He³, Fei Wang¹, Da-Hai Xu¹, Yue Wang¹, Jin-Wang¹, Wei-Hui Liu^{1

4}

Affiliations

¹ Department of Gastroenterology, Jianyang People's Hospital, Chengdu, China.
² Department of General Practice, Jianyang People's Hospital, Chengdu, China.
³ Department of Burn, Plastic, and Trauma Surgery, Jianyang People's Hospital, Chengdu, China.
⁴ Department of Gastroenterology and Hepatology, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China.

PMID: 41636323
DOI: 10.1177/10926429251414556

Abstract

Background: En bloc and R0 resection of nonpedunculated colonic lesions by conventional endoscopic mucosal resection (EMR) are challenging. Preliminary lesion molding-aided EMR (PM-EMR) is useful for reducing snaring slippage, which may increase successful en bloc and R0 resection rates. Herein, we compared PM-EMR and conventional EMR outcomes.

Methods: Overall, 112 patients with nonpedunculated colonic lesions measuring 8-15 mm were randomly allocated to either the PM-EMR group or the conventional EMR group. Baseline characteristics and treatment results were analyzed between the groups.

Results: En bloc resection and R0 resection were achieved in the PM-EMR group (100%, 94.6%) and the conventional EMR group (76.8%, 67.9%). For lesions ≥ 10 mm, en bloc and R0 resection rates were greater for PM-EMR than for conventional EMR (100.0% versus 74.4%; 94.4% versus 62.8%, respectively). For lesions with macroscopic morphologies indicating Is/IIa located in the left/right colon, PM-EMR was significantly better than conventional EMR for en bloc resection (100.0% versus 69.2%, 100% versus 76.5%; 100.0% versus 75.0%, 100.0% versus 68.2%, respectively) and R0 resection (100.0% versus 65.4%, 88.9% versus 52.9%; 100.0% versus 60.0%, 90.0% versus 63.6%, respectively).

Conclusions: PM-EMR is significantly better than conventional EMR regarding en bloc and R0 resection of 10-15 mm nonpedunculated colorectal lesions.

Keywords: R0 resection; complete resection; en bloc resection; endoscopic mucosal resection; preliminary lesion molding-aided (assisted) EMR (PM-EMR).