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Meta-analysis and systematic review of colorectal endoscopic mucosal resection Puli SR; Kakugawa Y; Gotoda T; Antillon D; Saito Y; Antillon MRWorld J Gastroenterol 2009[Sep]; 15 (34): 4273-7AIM: 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.|*Endoscopy, Gastrointestinal/statistics & numerical data[MESH]|Colonic Polyps/*surgery[MESH]|Colorectal Neoplasms/*surgery[MESH]|Gastric Mucosa/*surgery[MESH]|Humans[MESH]|Precancerous Conditions/*surgery[MESH] |
