Effect of endoscopic mucosal resection and endoscopic submucosal dissection on postoperative wound bleeding-related complications in patients with superficial esophageal cancer: A meta-analysis

Operative therapy for superficial esophagus carcinoma is the main way to treat the disease. Endoscopic excision of lesions in the esophagus has become an alternative to surgical treatment for patients with esophageal carcinoma. To overcome the disadvantages of endoscope mucosa excision (EMR), an endoscopic submucosal dissection (ESD) technique has been developed. Although ESD is one of the most effective methods of endoscopy in patients with digestive tract tumors, there are potential complications after surgery, including hemorrhage in the surgical area and stenosis of the esophagus. The objective of this study was to evaluate EMR versus ESD based on post-operative hemorrhage and esophagus stenosis. All the related articles were retrieved from the e-databases. The main results were postoperative perforation, hemorrhage, and stenosis after surgery. There were no statistically significant differences in the incidence of post-operative wound hemorrhage (OR, 1.08; 95% CI, 0.36-3.29 p=0.89). Similarly, there were no statistically significant differences in the rate of perforation after surgery (OR, 0.57; 95% CI, 0.17-1.95 p=0.37). There were no statistically significant differences in the incidence of esophageal stricture after surgery (OR, 1.15; 95% CI, 0.26-5.15 p=0.85). This analysis was different from the earlier meta-analysis because ESD and EMR did not show any notable differences with respect to the incidence of perforation after surgery, the hemorrhage of the wound or the stenosis of the esophagus. These findings must, however, be supported by more high-quality studies.