Rectal polyp reaching the dentate line: underwater EMR without?submucosal lift

摘要

A rectal polyp reaching the dentate line (RPDL) ischallenging to resect. Traditionally, such polyps arereferred for surgery, and patients are offered either majorabdominoperineal resection (with a high rate of adverseevents) or minimally invasive transanal endoscopic microsurgery (TEMS). Endoscopic submucosal dissection canalso be technically challenging, with a steep learningcurve and rates of adverse events of 2% for bleeding,4% for perforation, and 4% for recurrence.1.