PMID- 33269325
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20240330
IS  - 2364-3722 (Print)
IS  - 2196-9736 (Electronic)
IS  - 2196-9736 (Linking)
VI  - 8
IP  - 12
DP  - 2020 Dec
TI  - Underwater versus conventional endoscopic mucosal resection for colorectal 
      lesions: a systematic review and meta-analysis.
PG  - E1884-E1894
LID - 10.1055/a-1287-9621 [doi]
AB  - Background and study aims  Underwater endoscopic mucosal resection (UEMR) for 
      colorectal polyps has been reported to have good outcomes in recent studies. We 
      conducted a systematic review and meta-analysis comparing the effectiveness and 
      safety of UEMR to conventional EMR (CEMR). Methods  A comprehensive search of 
      multiple databases (through May 2020) was performed to identify studies that 
      reported outcome of UEMR and CEMR for colorectal lesions. Outcomes assessed 
      included incomplete resection, rate of recurrence, en bloc resection, adverse 
      events (AEs) for UEMR and CEMR. Results  A total of 1,651 patients with 1,704 
      polyps were included from nine studies. There was a significantly lower rate of 
      incomplete resection (odds ratio [OR]: 0.19 (95 % confidence interval (CI), 
      0.05-0.78, P  = 0.02) and polyp recurrence (OR: 0.41, 95 % CI, 0.24-0.72, P 
       = 0.002) after UEMR. Compared to CEMR, rates overall complications (relative 
      risk [RR]: 0.66 (95 % CI, 0.48-0.90) ( P  = 0.008), and intra-procedural bleeding 
      (RR: 0.59, 95 % CI, 0.41-0.84, P  = 0.004) were significantly lower with UEMR. 
      The recurrence rate was also lower for large non-pedunculated polyps >/= 10 mm (OR 
      0.24, 95 % CI, 0.10-0.57, P  = 0.001) and >/= 20 mm (OR 0.14, 95 % CI, 0.02-0.72, P 
       = 0.01). The rates of en bloc resection, delayed bleeding, perforation and 
      post-polypectomy syndrome were similar in both groups ( P  > 0.05). Conclusions  
      In this systematic review and meta-analysis, we found that UEMR is more effective 
      and safer than CEMR with lower rates of recurrence and AEs. UEMR use should be 
      encouraged over CEMR.
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 - Garg, Rajat
AU  - Garg R
AD  - Department of Hospital Medicine, Cleveland Clinic, Ohio, United States.
FAU - Singh, Amandeep
AU  - Singh A
AD  - Department of Gastroenterology, Hepatology and Nutrition, Digestive Diseases and 
      Surgery Institute; Cleveland Clinic, Cleveland, Ohio, United States.
FAU - Mohan, Babu P
AU  - Mohan BP
AD  - Department of Inpatient Medicine, University of Arizona, Banner University 
      Medical Center, Tucson, Arizona, United States.
FAU - Mankaney, Gautam
AU  - Mankaney G
AD  - Department of Gastroenterology, Hepatology and Nutrition, Digestive Diseases and 
      Surgery Institute; Cleveland Clinic, Cleveland, Ohio, United States.
FAU - Regueiro, Miguel
AU  - Regueiro M
AD  - Department of Gastroenterology, Hepatology and Nutrition, Digestive Diseases and 
      Surgery Institute; Cleveland Clinic, Cleveland, Ohio, United States.
FAU - Chahal, Prabhleen
AU  - Chahal P
AD  - Department of Gastroenterology, Hepatology and Nutrition, Digestive Diseases and 
      Surgery Institute; Cleveland Clinic, Cleveland, Ohio, United States.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20201127
PL  - Germany
TA  - Endosc Int Open
JT  - Endoscopy international open
JID - 101639919
PMC - PMC7695518
COIS- Competing interests The authors declare that they have no conflict of interest.
EDAT- 2020/12/04 06:00
MHDA- 2020/12/04 06:01
PMCR- 2020/12/01
CRDT- 2020/12/03 05:47
PHST- 2020/06/24 00:00 [received]
PHST- 2020/09/21 00:00 [accepted]
PHST- 2020/12/03 05:47 [entrez]
PHST- 2020/12/04 06:00 [pubmed]
PHST- 2020/12/04 06:01 [medline]
PHST- 2020/12/01 00:00 [pmc-release]
AID - 10.1055/a-1287-9621 [doi]
PST - ppublish
SO  - Endosc Int Open. 2020 Dec;8(12):E1884-E1894. doi: 10.1055/a-1287-9621. Epub 2020 
      Nov 27.