Is underwater endoscopic mucosal resection of colon polyps superior to conventional techniques? A network analysis of endoscopic mucosal resection and submucosal dissection

Abstract Background and study aims  Evidence from recent trials comparing conventional endoscopic mucosal resection (EMR) to underwater EMR (UEMR) have matured. However, studies comparing UEMR to endoscopic submucosal dissection (ESD) are lacking. Hence, we sought to conduct a comprehensive network...

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Published in:Endoscopy International Open 2022-01, Vol.10 (1), p.E154-E162
Main Authors: Tan, Darren Jun Hao, Ng, Cheng Han, Lim, Xiong Chang, Lim, Wen Hui, Yuen, Linus Zhen Han, Koh, Jin Hean, Nistala, Kameswara Rishi Yeshayahu, Ho, Khek-Yu, Chong, Choon Seng, Muthiah, Mark D.
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Language:English
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Summary:Abstract Background and study aims  Evidence from recent trials comparing conventional endoscopic mucosal resection (EMR) to underwater EMR (UEMR) have matured. However, studies comparing UEMR to endoscopic submucosal dissection (ESD) are lacking. Hence, we sought to conduct a comprehensive network meta-analysis to compare the efficacy of UEMR, ESD, and EMR. Methods  Embase and Medline databases were searched from inception to December 2020 for articles comparing UEMR with EMR and ESD. Outcomes of interest included rates of en bloc and complete polyp resection, risk of perforation and bleeding, and local recurrence. A network meta-analysis comparing all three approaches was conducted. In addition, a conventional comparative meta-analysis comparing UEMR to EMR was performed. Analysis was stratified according to polyp sizes (
ISSN:2364-3722
2196-9736
DOI:10.1055/a-1633-3230