PMID- 38503302
OWN - NLM
STAT- Publisher
LR  - 20240319
IS  - 1438-8812 (Electronic)
IS  - 0013-726X (Linking)
DP  - 2024 Mar 19
TI  - Cold endoscopic mucosal resection versus cold snare polypectomy for colorectal 
      lesions: a systematic review and meta-analysis of randomized controlled trials.
LID - 10.1055/a-2275-5349 [doi]
AB  - BACKGROUND: Cold resection of colorectal lesions is widely performed because of 
      its safety and effectiveness; however, it remains uncertain whether adding 
      submucosal injection could improve the efficacy and safety. We aimed to compare 
      cold endoscopic mucosal resection (C-EMR) versus cold snare polypectomy (CSP) for 
      colorectal lesions. METHODS: We performed a systematic review of randomized 
      controlled trials (RCTs) identified from PubMed, Cochrane Library, and Embase. 
      The primary outcome was complete resection. Secondary outcomes were procedure 
      time, en bloc resection, and adverse events (AEs). Prespecified subgroup analyses 
      based on the size and morphology of the polyps were performed. The random-effects 
      model was used to calculate the pooled risk ratio (RR) and mean difference, with 
      corresponding 95%CIs, for dichotomous and continuous variables, respectively. 
      Heterogeneity was assessed using the Cochran Q test and I (2) statistics. 
      RESULTS: 7 RCTs were included, comprising 1556 patients, with 2287 polyps 
      analyzed. C-EMR and CSP had similar risk ratios for complete resection (RR 1.02, 
      95%CI 0.98-1.07), en bloc resection (RR 1.08, 95%CI 0.82-1.41), and AEs (RR 0.74, 
      95%CI 0.41-1.32). C-EMR had a longer procedure time (mean difference 42.1 
      seconds, 95%CI 14.5-69.7 seconds). In stratified subgroup analyses, the risk was 
      not statistically different between C-EMR and CSP for complete resection in 
      polyps<10 mm or >/=10 mm, or for complete resection, en bloc resection, and AEs in 
      the two groups among nonpedunculated polyps. CONCLUSIONS: The findings of this 
      meta-analysis suggest that C-EMR has similar efficacy and safety to CSP, but 
      significantly increases the procedure time. PROSPERO: CRD42023439605.
CI  - Thieme. All rights reserved.
FAU - Arruda do Espirito Santo, Paula
AU  - Arruda do Espirito Santo P
AUID- ORCID: 0000-0001-6294-9885
AD  - Diagnostic Imaging and Specialized Diagnosis Unit, University Hospital of Federal 
      University of Sao Carlos, Sao Carlos, Brazil.
FAU - Meine, Gilmara Coelho
AU  - Meine GC
AUID- ORCID: 0000-0001-5389-4368
AD  - Department of Internal Medicine (Division of Gastroenterology), FEEVALE 
      University, Novo Hamburgo, Brazil.
FAU - Baraldo, Stefano
AU  - Baraldo S
AUID- ORCID: 0000-0002-6359-9167
AD  - Department of Endoscopy, Barretos Cancer Hospital, Barretos, Brazil.
FAU - Barbosa, Eduardo Cerchi
AU  - Barbosa EC
AUID- ORCID: 0000-0001-5500-4701
AD  - Department of Internal Medicine, Evangelical University of Goias, Anapolis, 
      Brazil.
LA  - eng
PT  - Journal Article
DEP - 20240319
PL  - Germany
TA  - Endoscopy
JT  - Endoscopy
JID - 0215166
SB  - IM
COIS- The authors declare that they have no conflict of interest.
EDAT- 2024/03/20 00:42
MHDA- 2024/03/20 00:42
CRDT- 2024/03/19 19:44
PHST- 2024/03/20 00:42 [medline]
PHST- 2024/03/20 00:42 [pubmed]
PHST- 2024/03/19 19:44 [entrez]
AID - 10.1055/a-2275-5349 [doi]
PST - aheadofprint
SO  - Endoscopy. 2024 Mar 19. doi: 10.1055/a-2275-5349.