Endoscopic mucosal resection and endoscopic submucosal dissection for colorectal lesions: A systematic review

被引：137
作者：
De Ceglie, Antonella [1 ]
Hassan, Cesare [2 ]
Mangiavillano, Benedetto [1 ]
Matsuda, Takahisa [3 ]
Saito, Yutaka [3 ]
Ridola, Lorenzo [4 ]
Bhandari, Pradeep [5 ]
Boeri, Federica [1 ]
Conio, Massimo [1 ]
机构：
[1] Gen Hosp, Dept Gastroenterol, San Remo, Italy
[2] Nuovo Regina Margherita Hosp, Dept Gastroenterol, Rome, Italy
[3] Natl Canc Ctr, Endoscopy Div, Tokyo, Japan
[4] Sapienza Univ, Gastroenterol Unit, Rome, Italy
[5] Portsmouth Hosp NHS Trust, Dept Gastroenterol, Portsmouth, Hants, England
来源：
CRITICAL REVIEWS IN ONCOLOGY HEMATOLOGY | 2016年 / 104卷
关键词：
Colorectal lesion; laterally spreading tumor LST; endoscopic mucosa resection EMR; endoscopic submucosal dissection ESD; LATERALLY SPREADING TUMORS; ARGON PLASMA COAGULATION; EN-BLOC RESECTION; LARGE SESSILE; PIECEMEAL RESECTION; CLINICAL-OUTCOMES; LOCAL RECURRENCE; COLONIC POLYPS; RISK-FACTORS; NEOPLASIA;
D O I：
10.1016/j.critrevonc.2016.06.008
中图分类号：
R73 [肿瘤学];
学科分类号：
100214 ;
摘要：
Aim: To assess the efficacy and safety of endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD) for the treatment of colorectal lesions. Methods: A literature search was conducted from January 2000 to May 2015. The main outcomes were: recurrence after "en bloc" and "piecemeal" resection; procedure related adverse events; the EMR endoscopic success rate and the completely eradicated resection rate (R0) after ESD. Results: A total of 66 studies were included in the analysis. The total number of lesions was 17950 (EMR: 11.873; ESD: 6077). Recurrence rate was higher in the EMR than ESD group (765/73031 vs. 50/3910 OR 8.19, 95% CI 6.2-10.9 p < 0.0001). EMR-en bloc resection was achieved in 6793/10803 lesions (62.8%) while ESD-en bloc resection was obtained in 5500/6077 lesions (90.5%) (OR 0.18, p < 0.0001, 95% CI 0.16-0.2). Perforation occurred more frequently in ESD than in EMR group (p < 0.0001, OR 0.19, 95% CI 0.15-0.24). Conclusions: Endoscopic resection of large colorectal lesions is safe and effective. Compared with EMR, ESD results in higher "en bloc" resection rate and lower local recurrence rate, however ESD has high procedure-related complication rates. (C) 2016 Elsevier Ireland Ltd. All rights reserved.
引用
收藏
页码：138 / 155
页数：18
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