Endocut Q (effect 2, effect 3 and effect 4) commonly is used for endoscopic mucosal resection (EMR) when removing colorectal polyps. However, there is debate over the type of electrosurgical setting of Endocut Q being recommended in clinical practice. We performed a randomized controlled trial to assess effectiveness and safety of three effects with EMR for removal of non-pedunculated 10- to 20-mm colorectal polyps.

Patients with non-pedunculate colorectal polyps undergoing EMR were randomly allocated into effect 2, effect 3, and effect 4 groups. The primary outcome was rates of intra-procedural bleeding. Secondary outcomes were rates of post-procedural bleeding, perforation, complete resection, en bloc resection, R0 resection, and residual polyps.

A total of 2637 eligible patients were included in the study and randomly assigned into the effect 2, effect 3, or effect 4 group. There were no significant differences among the three groups in baseline characteristics (P > 0.05). In addition, no significant differences were observed in rates of post-procedural bleeding, perforation, complete resection, en bloc resection, R0 resection, residual polyps, or post-polypectomy syndrome (P > 0.05). However, the rate of intra-procedural bleeding was significantly lower in the effect 2 group than in the effect 3 and effect 4 groups (4.0% vs. 12.2% vs. 12.7%, P < 0.01).

Endocut Q (effect 2, effect 3 and effect 4) was effective and safe for removing 10- to 20-mm non-pedunculated colorectal polyps. However, effect 2 may be superior to effect 3 and effect 4 in reducing intra-procedural bleeding.

Received: 23 September 2024

Accepted after revision: 13 July 2025

Accepted Manuscript online:
22 July 2025

Article published online:
28 August 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/).

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Bibliographical Record
Su Luo, Feng Xiong, Sheng-gang Zhan, Zhenglei Xu, Ding-guo Zhang, Ting-ting Liu, Ying-xue Li, Cheng Wei, Ben-hua Wu, Yi-teng Meng, Rui-yue Shi, Jun Yao, Li-sheng Wang, De-feng Li. Comparison of three electrosurgical modes for endoscopic mucosal resection of 10- to 20-mm colorectal polyps: Randomized controlled trial. Endosc Int Open 2025; 13: a26636177.
DOI: 10.1055/a-2663-6177