PMID- 33015327
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20201006
IS  - 2364-3722 (Print)
IS  - 2196-9736 (Electronic)
IS  - 2196-9736 (Linking)
VI  - 8
IP  - 10
DP  - 2020 Oct
TI  - Underwater vs conventional endoscopic mucosal resection in the management of 
      colorectal polyps: a systematic review and meta-analysis.
PG  - E1264-E1272
LID - 10.1055/a-1214-5692 [doi]
AB  - Background  Recently, underwater endoscopic mucosal resection (UEMR) has shown 
      promising results in the management of colorectal polyps. Some studies have shown 
      better outcomes compared to conventional endoscopic mucosal resection (EMR). We 
      conducted this systematic review and meta-analysis to compare UEMR and EMR in the 
      management of colorectal polyps. Methods  We searched several databases from 
      inception to November 2019 to identify studies comparing UEMR and EMR. Outcomes 
      assessed included rates of en bloc resection, complete macroscopic resection, 
      recurrent/residual polyps on follow-up colonoscopy, complete resection confirmed 
      by histology and adverse events. Pooled risk ratios (RR) with 95 % confidence 
      interval were calculated using a fixed effect model. Heterogeneity was assessed 
      by I (2) statistic. Funnel plots and Egger's test were used to assess publication 
      bias. We used the Newcastle-Ottawa scale (NOS) for assessment of quality of 
      observational studies, and the Cochrane tool for assessing risk of bias for RCTs 
      Results  Seven studies with 1291 patients were included; two were randomized 
      controlled trials and five were observational. UEMR demonstrated statistically 
      significantly better efficacy in rates of en bloc resection, pooled RR 1.16 
      (1.08, 1.26), complete macroscopic resection, pooled RR 1.28 (1.18, 1.39), 
      recurrent/residual polyps; pooled RR 0.26 (0.12, 0.56) and complete resection 
      confirmed by histology; pooled RR 0.75 (0.57, 0.98). There was no significant 
      difference in adverse events (AEs); pooled RR 0.68 (0.44, 1.05). Conclusions  
      This meta-analysis found statistically significantly better rates of en bloc 
      resection, complete macroscopic resection, and lower risk of recurrent/residual 
      polyps with UEMR compared to EMR. We found no significant difference in AEs 
      between the two techniques.
CI  - The Author(s). This is an open access article published by Thieme under the terms 
      of the Creative Commons Attribution-NonDerivative-NonCommercial License, 
      permitting copying and reproduction so long as the original work is given 
      appropriate credit. Contents may not be used for commecial purposes, or adapted, 
      remixed, transformed or built upon. 
      (https://creativecommons.org/licenses/by-nc-nd/4.0/).
FAU - Kamal, Faisal
AU  - Kamal F
AD  - Division of Gastroenterology, University of Tennessee Health Science Center, 
      Memphis, Tennessee, United States.
FAU - Khan, Muhammad Ali
AU  - Khan MA
AD  - Division of Gastroenterology, University of Alabama at Birmingham, Birmingham, 
      Alabama, United States.
FAU - Lee-Smith, Wade
AU  - Lee-Smith W
AD  - Carlson and Mulford Libraries, University of Toledo, Ohio, United States.
FAU - Khan, Zubair
AU  - Khan Z
AD  - Division of Gastroenterology, University of Texas - Houston, Houston, Texas, 
      United States.
FAU - Sharma, Sachit
AU  - Sharma S
AD  - Division of Internal Medicine, University of Toledo, Ohio, United States.
FAU - Tombazzi, Claudio
AU  - Tombazzi C
AD  - Division of Gastroenterology, University of Tennessee Health Science Center, 
      Memphis, Tennessee, United States.
FAU - Ahmad, Dina
AU  - Ahmad D
AD  - Division of Gastroenterology, University of Tennessee Health Science Center, 
      Memphis, Tennessee, United States.
FAU - Ismail, Mohammad Kashif
AU  - Ismail MK
AD  - Division of Gastroenterology, University of Tennessee Health Science Center, 
      Memphis, Tennessee, United States.
FAU - Howden, Colin W
AU  - Howden CW
AD  - Division of Gastroenterology, University of Tennessee Health Science Center, 
      Memphis, Tennessee, United States.
FAU - Binmoeller, Kenneth F
AU  - Binmoeller KF
AD  - Division of Gastroenterology, California Pacific Medical Center, San Francisco, 
      California, United States.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20200922
PL  - Germany
TA  - Endosc Int Open
JT  - Endoscopy international open
JID - 101639919
PMC - PMC7508646
COIS- Competing interests The authors declare that they have no conflict of interest.
EDAT- 2020/10/06 06:00
MHDA- 2020/10/06 06:01
PMCR- 2020/10/01
CRDT- 2020/10/05 06:22
PHST- 2020/02/28 00:00 [received]
PHST- 2020/05/25 00:00 [accepted]
PHST- 2020/10/05 06:22 [entrez]
PHST- 2020/10/06 06:00 [pubmed]
PHST- 2020/10/06 06:01 [medline]
PHST- 2020/10/01 00:00 [pmc-release]
AID - 10.1055/a-1214-5692 [doi]
PST - ppublish
SO  - Endosc Int Open. 2020 Oct;8(10):E1264-E1272. doi: 10.1055/a-1214-5692. Epub 2020 
      Sep 22.