PMID- 37818454
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20231031
IS  - 2364-3722 (Print)
IS  - 2196-9736 (Electronic)
IS  - 2196-9736 (Linking)
VI  - 11
IP  - 10
DP  - 2023 Oct
TI  - Underwater versus conventional endoscopic mucosal resection for colorectal 
      lesions: An updated meta-analysis of randomized controlled trials.
PG  - E935-E942
LID - 10.1055/a-2150-9899 [doi]
AB  - Background and study aims Colorectal malignancy is a leading cause of death. 
      Conventional endoscopic mucosal resection (CEMR) is a strategy used to resect 
      precancerous lesions that involves injecting fluid beneath a polyp to create a 
      gap for resection. Underwater endoscopic mucosal resection (UEMR) is a newer 
      method that forgoes injection, instead filling the intestinal cavity with water 
      to facilitate polyp resection. Our aim was to compare the safety and efficacy of 
      these approaches by synthesizing the most contemporary evidence. Methods PubMed, 
      Embase, and Cochrane libraries were searched from inception through November 11, 
      2022 for randomized controlled trials (RCTs) comparing UEMR and CEMR for 
      resection of colorectal lesions. The primary outcome was the rate of en bloc 
      resection and secondary outcomes included recurrence, procedure time, and adverse 
      events (AEs). Results A total of 2539 studies were identified through our 
      systematic literature search. After screening, seven RCTs with a total of 1581 
      polyps were included. UEMR was associated with significantly increased rates of 
      en bloc resection (RR 1.18 [1.03, 1.35]; I (2) = 76.6%) versus conventional 
      approaches. No significant differences were found in procedure time, recurrence, 
      or AEs. Conclusions UEMR is a promising effective technique for removal of 
      colorectal lesions. The most contemporary literature indicates that it improves 
      en bloc resection rate without increasing procedure time, recurrence, or AEs 
      (PROSPERO ID CRD42022374935).
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 commercial purposes, or adapted, 
      remixed, transformed or built upon. 
      (https://creativecommons.org/licenses/by-nc-nd/4.0/).
FAU - Chowdhury, Aneesa Rahman
AU  - Chowdhury AR
AD  - Division of Gastrointestinal and Liver Diseases, University of Southern 
      California, Los Angeles, United States.
FAU - Kim, Jin Sun
AU  - Kim JS
AD  - Division of Gastrointestinal and Liver Diseases, University of Southern 
      California, Los Angeles, United States.
FAU - Xu, Mimi
AU  - Xu M
AD  - Division of Gastrointestinal and Liver Diseases, University of Southern 
      California, Los Angeles, United States.
FAU - Tom, Chloe
AU  - Tom C
AD  - Division of Gastrointestinal and Liver Diseases, University of Southern 
      California, Los Angeles, United States.
FAU - Narala, Rachan
AU  - Narala R
AD  - Division of Gastrointestinal and Liver Diseases, University of Southern 
      California, Los Angeles, United States.
FAU - Kong, Niwen
AU  - Kong N
AD  - Division of Gastrointestinal and Liver Diseases, University of Southern 
      California, Los Angeles, United States.
FAU - Lee, Helen
AU  - Lee H
AD  - Division of Gastrointestinal and Liver Diseases, University of Southern 
      California, Los Angeles, United States.
FAU - Vazquez, Alejandro
AU  - Vazquez A
AD  - Division of Gastrointestinal and Liver Diseases, University of Southern 
      California, Los Angeles, United States.
FAU - Sahakian, Ara
AU  - Sahakian A
AD  - Division of Gastrointestinal and Liver Diseases, University of Southern 
      California, Los Angeles, United States.
FAU - Phan, Jennifer
AU  - Phan J
AD  - Division of Gastrointestinal and Liver Diseases, University of Southern 
      California, Los Angeles, United States.
FAU - Buxbaum, James
AU  - Buxbaum J
AD  - Division of Gastrointestinal and Liver Diseases, University of Southern 
      California, Los Angeles, United States.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20231009
PL  - Germany
TA  - Endosc Int Open
JT  - Endoscopy international open
JID - 101639919
PMC - PMC10562051
OTO - NOTNLM
OT  - Colorectal cancer
OT  - Endoscopic resection (polypectomy, ESD, EMRc, ...)
OT  - Endoscopy Lower GI Tract
OT  - Polyps / adenomas / ...
COIS- Conflict of Interest The authors declare that they have no conflict of interest.
EDAT- 2023/10/11 06:45
MHDA- 2023/10/11 06:46
PMCR- 2023/10/01
CRDT- 2023/10/11 04:00
PHST- 2023/02/22 00:00 [received]
PHST- 2023/07/31 00:00 [accepted]
PHST- 2023/10/11 06:46 [medline]
PHST- 2023/10/11 06:45 [pubmed]
PHST- 2023/10/11 04:00 [entrez]
PHST- 2023/10/01 00:00 [pmc-release]
AID - EIO-2023-02-2947-REV [pii]
AID - 10.1055/a-2150-9899 [doi]
PST - epublish
SO  - Endosc Int Open. 2023 Oct 9;11(10):E935-E942. doi: 10.1055/a-2150-9899. 
      eCollection 2023 Oct.