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.

Endoscopic mucosal resection and endoscopic submucosal dissection for colorectal lesions: A systematic review / De Ceglie, A.; Hassan, C.; Mangiavillano, B.; Matsuda, T.; Saito, Y.; Ridola, L.; Bhandari, P.; Boeri, F.; Conio, M.. - In: CRITICAL REVIEWS IN ONCOLOGY HEMATOLOGY. - ISSN 1040-8428. - 104:(2016), pp. 138-155. [10.1016/j.critrevonc.2016.06.008]

Endoscopic mucosal resection and endoscopic submucosal dissection for colorectal lesions: A systematic review

Ridola L.;
2016

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.
2016
Colorectal lesion; EMR; endoscopic mucosa resection; endoscopic submucosal dissection; ESD; laterally spreading tumor; LST
01 Pubblicazione su rivista::01a Articolo in rivista
Endoscopic mucosal resection and endoscopic submucosal dissection for colorectal lesions: A systematic review / De Ceglie, A.; Hassan, C.; Mangiavillano, B.; Matsuda, T.; Saito, Y.; Ridola, L.; Bhandari, P.; Boeri, F.; Conio, M.. - In: CRITICAL REVIEWS IN ONCOLOGY HEMATOLOGY. - ISSN 1040-8428. - 104:(2016), pp. 138-155. [10.1016/j.critrevonc.2016.06.008]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/1439032
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