Original articleClinical endoscopyEfficacy and adverse events of EMR and endoscopic submucosal dissection for the treatment of colon neoplasms: a meta-analysis of studies comparing EMR and endoscopic submucosal dissection
Section snippets
Retrieval strategy and quality assessment
A meta-analysis was conducted to evaluate the predominance of EMR and ESD for removing colon tumors. The data included in PubMed (published from 2005 to 2013) and the Cochrane Controlled Trials Register (2005 to 2013) were searched. The keywords used were as follows: a combination of “endoscopic mucosal resection,” “large polyp resection,” “piecemeal polypectomy,” “submucosal injection,” “hot biopsy,” “strip biopsy” or “endoscopic submucosal dissection” and “colon,” “colonic” or “colorectal.”
Evaluation and details of the selected studies
A total of 247 reports were retrieved (Fig. 1). After screening the titles, abstracts, or full text and excluding reviews, case reports, uncontrolled tests, and basic research studies, 9 studies were selected.24, 28, 42, 43, 44, 45, 46, 47, 48 Among these 9 studies, 1 study, in which clinical records were collected from 18 institutions in Japan, was excluded because some of the enrolled cases overlapped with those of other reports.48 Thereafter, the risk of bias was assessed according to the
Discussion
The present meta-analysis compared the efficacy of and adverse events associated with EMR and ESD for removing colon tumors based on 8 recently published articles.24, 28, 42, 43, 44, 45, 46, 47 The findings indicated that the rates of en bloc resection and curative resection were much higher, and the rate of recurrence was much lower in the ESD group (91.7%, 80.3%, and 0.9%, respectively) than in the EMR group (46.7%, 42.3%, and 12.2%, respectively). Furthermore, the size of tumors treated with
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DISCLOSURE: All authors disclosed no financial relationships relevant to this article.
See CME section; p. 748.
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