Antonella De Ceglie1, Cesare Hassan2, Benedetto Mangiavillano1, Takahisa Matsuda3, Yutaka Saito3, Lorenzo Ridola4, Pradeep Bhandari5, Federica Boeri1, Massimo Conio6. 1. Gastroenterology Department, General Hospital, Sanremo, Italy. 2. Gastroenterology Department, Nuovo Regina Margherita Hospital, Rome, Italy. 3. Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan. 4. Gastroenterology Unit, "Sapienza" University, Rome, Italy. 5. Gastroenterology Department, Portsmouth Hospital NHS Trust, Portsmouth, Hampshire, UK. 6. Gastroenterology Department, General Hospital, Sanremo, Italy. Electronic address: mxconio@tin.it.
Abstract
AIM: To assess the efficacy and safety of endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD) for the treatment of colorectal lesions. METHODS: A literature search was conducted from January 2000 to May 2015. The main outcomes were: recurrence after "en bloc" and "piecemeal" resection; procedure related adverse events; the EMR endoscopic success rate and the completely eradicated resection rate (R0) after ESD. RESULTS: A total of 66 studies were included in the analysis. The total number of lesions was 17950 (EMR: 11.873; ESD: 6077). Recurrence rate was higher in the EMR than ESD group (765/7303l vs. 50/3910 OR 8.19, 95% CI 6.2-10.9 p<0.0001). EMR-en bloc resection was achieved in 6793/10803 lesions (62.8%) while ESD-en bloc resection was obtained in 5500/6077 lesions (90.5%) (OR 0.18, p<0.0001, 95% CI 0.16-0.2). Perforation occurred more frequently in ESD than in EMR group (p<0.0001, OR 0.19, 95% CI 0.15-0.24). CONCLUSIONS: Endoscopic resection of large colorectal lesions is safe and effective. Compared with EMR, ESD results in higher "en bloc" resection rate and lower local recurrence rate, however ESD has high procedure-related complication rates.
AIM: To assess the efficacy and safety of endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD) for the treatment of colorectal lesions. METHODS: A literature search was conducted from January 2000 to May 2015. The main outcomes were: recurrence after "en bloc" and "piecemeal" resection; procedure related adverse events; the EMR endoscopic success rate and the completely eradicated resection rate (R0) after ESD. RESULTS: A total of 66 studies were included in the analysis. The total number of lesions was 17950 (EMR: 11.873; ESD: 6077). Recurrence rate was higher in the EMR than ESD group (765/7303l vs. 50/3910 OR 8.19, 95% CI 6.2-10.9 p<0.0001). EMR-en bloc resection was achieved in 6793/10803 lesions (62.8%) while ESD-en bloc resection was obtained in 5500/6077 lesions (90.5%) (OR 0.18, p<0.0001, 95% CI 0.16-0.2). Perforation occurred more frequently in ESD than in EMR group (p<0.0001, OR 0.19, 95% CI 0.15-0.24). CONCLUSIONS: Endoscopic resection of large colorectal lesions is safe and effective. Compared with EMR, ESD results in higher "en bloc" resection rate and lower local recurrence rate, however ESD has high procedure-related complication rates.
Authors: James Weiquan Li; Tiing Leong Ang; Lai Mun Wang; Andrew Boon Eu Kwek; Malcolm Teck Kiang Tan; Kwong Ming Fock; Eng Kiong Teo Journal: Singapore Med J Date: 2019-02-18 Impact factor: 1.858
Authors: Patrick Aepli; Dominique Criblez; Stephan Baumeler; Jan Borovicka; Remus Frei Journal: United European Gastroenterol J Date: 2017-08-23 Impact factor: 4.623
Authors: Chan Hyuk Park; Dong-Hoon Yang; Jong Wook Kim; Jie-Hyun Kim; Ji Hyun Kim; Yang Won Min; Si Hyung Lee; Jung Ho Bae; Hyunsoo Chung; Kee Don Choi; Jun Chul Park; Hyuk Lee; Min-Seob Kwak; Bun Kim; Hyun Jung Lee; Hye Seung Lee; Miyoung Choi; Dong-Ah Park; Jong Yeul Lee; Jeong-Sik Byeon; Chan Guk Park; Joo Young Cho; Soo Teik Lee; Hoon Jai Chun Journal: Intest Res Date: 2020-10-13