PMID- 38026781
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20231201
IS  - 2364-3722 (Print)
IS  - 2196-9736 (Electronic)
IS  - 2196-9736 (Linking)
VI  - 11
IP  - 11
DP  - 2023 Nov
TI  - Colorectal endoscopic submucosal dissection in the West: A systematic review and 
      meta-analysis.
PG  - E1082-E1091
LID - 10.1055/a-2181-5929 [doi]
AB  - Background and study aims The advantages of endoscopic submucosal dissection 
      (ESD) over endoscopic mucosal resection for large colorectal neoplasms are well 
      established; however, the technical challenges and lack of adequate training in 
      ESD limit its widespread adoption in Western countries. Methods A literature 
      search was performed in Medline, Embase, Web of Science, and the Cochrane Library 
      for studies conducted in non-Asian countries evaluating the effectiveness of 
      colorectal ESD. A random effects model was used to obtain pooled en bloc, R0 
      resection rates, and adverse events (AEs). Results Thirty-three studies 
      comprising 3,958 ESD procedures met the inclusion criteria. Of the polyps, 96.7% 
      (2,817 of 2913) were >/= 2 cm. Pooled en bloc resection (31 studies), R0 resection 
      (29 studies), and curative resection rates were 84.6% (95% confidence interval 
      [CI] [83.3%-85.9%]), 75.6% (95% CI [74.1%-77.0%]), and 81.9% (95% CI 
      [78.6%-84.9%]), respectively. Surgery for invasive cancer was performed in 4.8% 
      (23 studies). ESD-related perforation (25 studies) was observed in 5.5% and 
      bleeding in 4.1% (delayed bleeding 3.4%). 1.8% of patients underwent surgery for 
      procedure-related complications. A high degree of heterogeneity was observed for 
      en bloc resection, R0 resection, and curative resection. Heterogeneity for AEs 
      (perforation [I (2) 13%], delayed bleeding [I (2) 30%], and overall bleeding [I 
      (2) 49%]) was low to moderate. Conclusions The effectiveness of colorectal ESD 
      for large colorectal polyps and early colorectal cancers is improving in Western 
      countries, and recent resection rates are comparable to that seen in Asia. 
      Colorectal perforation is still observed in about 5% of ESD; however, < 2% of 
      patients need emergency surgery for AEs.
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 - Singh, Ritu Raj
AU  - Singh RR
AUID- ORCID: 0000-0002-8889-869X
AD  - Public Health, Johns Hopkins University Bloomberg School of Public Health, 
      Baltimore, United States. RINGGOLD: 25802
FAU - Nanavati, Julie
AU  - Nanavati J
AD  - Library, Johns Hopkins Welch Medical Library, Baltimore, United States. RINGGOLD: 
      41531
FAU - Gopakumar, Harishankar
AU  - Gopakumar H
AUID- ORCID: 0000-0002-4921-8794
AD  - Gastroenterology, University of Illinois College of Medicine at Peoria, Peoria, 
      United States. RINGGOLD: 17120
FAU - Kumta, Nikhil A
AU  - Kumta NA
AD  - Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York, 
      United States. RINGGOLD: 5925
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20231127
PL  - Germany
TA  - Endosc Int Open
JT  - Endoscopy international open
JID - 101639919
PMC - PMC10681808
OTO - NOTNLM
OT  - Colorectal cancer
OT  - Endoscopic resection (polypectomy, ESD, EMRc, ...)
OT  - Endoscopy Lower GI Tract
COIS- Conflict of Interest Ritu R. Singh: No conflict of interest Julie Nanavati: No 
      conflict of interest Harishankar Gopakumar: No conflict of interest Nikhil Kumta: 
      Consultant for Apollo Endosurgery, Boston Scientific, and Olympus.
EDAT- 2023/11/29 18:41
MHDA- 2023/11/29 18:42
PMCR- 2023/11/01
CRDT- 2023/11/29 16:57
PHST- 2023/02/22 00:00 [received]
PHST- 2023/09/11 00:00 [accepted]
PHST- 2023/11/29 18:42 [medline]
PHST- 2023/11/29 18:41 [pubmed]
PHST- 2023/11/29 16:57 [entrez]
PHST- 2023/11/01 00:00 [pmc-release]
AID - EIO-2023-02-2949-REV [pii]
AID - 10.1055/a-2181-5929 [doi]
PST - epublish
SO  - Endosc Int Open. 2023 Nov 27;11(11):E1082-E1091. doi: 10.1055/a-2181-5929. 
      eCollection 2023 Nov.