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Meta-Analysis
. 2009 Sep 14;15(34):4273-7.
doi: 10.3748/wjg.15.4273.

Meta-analysis and systematic review of colorectal endoscopic mucosal resection

Srinivas R Puli  1 , Yasuo Kakugawa, Takuji Gotoda, Daphne Antillon, Yutaka Saito, Mainor R Antillon
Affiliations
Meta-Analysis

Meta-analysis and systematic review of colorectal endoscopic mucosal resection

Srinivas R Puli et al. World J Gastroenterol. .

Abstract

Aim: To evaluate the proportion of successful complete cure en-bloc resections of large colorectal polyps achieved by endoscopic mucosal resection (EMR).

Methods: Studies using the EMR technique to resect large colorectal polyps were selected. Successful complete cure en-bloc resection was defined as one piece margin-free polyp resection. Articles were searched for in Medline, Pubmed, and the Cochrane Control Trial Registry, among other sources.

Results: An initial search identified 2620 reference articles, from which 429 relevant articles were selected and reviewed. Data was extracted from 25 studies (n = 5221) which met the inclusion criteria. All the studies used snares to perform EMR. Pooled proportion of en-bloc resections using a random effect model was 62.85% (95% CI: 51.50-73.52). The pooled proportion for complete cure en-bloc resections using a random effect model was 58.66% (95% CI: 47.14-69.71). With higher patient load (> 200 patients), this complete cure en-bloc resection rate improves from 44.19% (95% CI: 24.31-65.09) to 69.17% (95% CI: 51.11-84.61).

Conclusion: EMR is an effective technique for the resection of large colorectal polyps and offers an alternative to surgery.

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Figures

Figure 1
Figure 1
Search results.
Figure 2
Figure 2
Forrest plot showing successful en-bloc (A) and cure en-bloc (B) resection.
Figure 3
Figure 3
Funnel plot showing publication bias for successful cure en-bloc resection.
See this image and copyright information in PMC

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