Investigation of the efficacy and safety of endoscopic wide band resection in the treatment of colorectal polyps.

Background and studys purpose: Endoscopic band ligation is commonly used in gastroenterology but limited in colorectal polyps (CRPs) treatment due to narrow cap diameters. Endoscopic mucosal resection and endoscopic submucosal dissection (ESD) are effective but carry higher bleeding risks in patients with concomitant comorbidities. Considering the narrowest part of the colon, the rectosigmoid junction measures approximately 2.5 cm, we developed a custom endoscopic wide band resection (EWBR) cap with a 24 mm external diameter for CRPs <25 mm, particularly in high-risk patients. This study evaluates the efficacy and safety of EWBR.

Patients and methods: We prospectively collected and analyzed the outcomes of 32 patients with CRPs treated using EWBR and 34 matched patients treated with ESD between November 2020 and December 2024.

Main results: The groups were similar in age, gender, and lesion size (all P  > 0.05). Comorbidities were significantly more common in the EWBR group (78.6 vs. 8.8%; P  < 0.001). EWBR was associated with shorter procedure time (14.2 vs. 35 min; P  < 0.001), lower rates of prolonged bleeding that extended the procedure (3.1 vs. 52.9%; P  < 0.001), smaller hemoglobin decreases (0.55 vs. 1.17 g/dl; P  = 0.002), and shorter hospital stays (1.03 vs. 2.11 days; P  = 0.001). Only one patient (3.1%) in the EWBR group developed asymptomatic minor strictures. No recurrences were observed in either group.

Conclusion: EWBR is a safe and effective alternative for CRPs <25 mm, especially in high-risk patients. It reduces procedure time, bleeding, and hospital stay, making it a promising therapeutic option.