{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T14:09:09Z","timestamp":1790172549430,"version":"4.1.0"},"reference-count":10,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,10,22]],"date-time":"2025-10-22T00:00:00Z","timestamp":1761091200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,10,22]],"date-time":"2025-10-22T00:00:00Z","timestamp":1761091200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["DEN Open"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Endoscopic mucosal resection (EMR) has been widely adopted as an endoscopic treatment for colorectal tumors. However, in non\u2010lifting lesions, EMR often becomes technically challenging, leading to piecemeal resection or residual tumor. Recently, underwater EMR (UEMR) has been developed as a novel technique that allows mucosal and submucosal layers to float under water, facilitating snare resection without submucosal injection. UEMR has been reported to improve en bloc resection rates and shorten procedure time compared with conventional EMR, and its usefulness has been demonstrated in non\u2010lifting and residual lesions. We encountered a case in which a 78\u2010year\u2010old woman had a small IIa+IIc\u2010type lesion of the sigmoid colon that could not be completely removed by EMR at a previous hospital due to non\u2010lifting and snare slippage, resulting in only partial resection. She was subsequently referred to our hospital for further treatment. At our hospital, UEMR was successfully performed, achieving en bloc resection. Histopathological examination revealed well\u2010differentiated tubular adenocarcinoma with 560 \u00b5m submucosal invasion, negative resection margins, and no lymphovascular invasion, thus fulfilling the criteria for curative resection. This case highlights the illustrative and educational significance of applying UEMR, rather than endoscopic submucosal dissection, to achieve a safe and time\u2010efficient curative resection for a small non\u2010lifting colorectal carcinoma. UEMR may represent a potential salvage option in selected EMR\u2010difficult cases, although further accumulation of cases is warranted to clarify its role.<\/jats:p>","DOI":"10.1002\/deo2.70225","type":"journal-article","created":{"date-parts":[[2025,10,22]],"date-time":"2025-10-22T09:56:19Z","timestamp":1761126979000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Underwater Endoscopic Mucosal Resection as a Salvage Strategy for a Non\u2010Lifting Early Sigmoid Colon Carcinoma After Failed Conventional Endoscopic Mucosal Resection: A Case Report"],"prefix":"10.1002","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-7271-3106","authenticated-orcid":false,"given":"Hiroshi","family":"Sawaguchi","sequence":"first","affiliation":[{"name":"Department of Medicine Division of Gastroenterology and Hepatology Shinshu University School of Medicine Nagano 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of Clinical Laboratory Sciences Shinshu University School of Medicine Nagano Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0091-8343","authenticated-orcid":false,"given":"Tadanobu","family":"Nagaya","sequence":"additional","affiliation":[{"name":"Department of Medicine Division of Gastroenterology and Hepatology Shinshu University School of Medicine Nagano 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