title: Meta-analysis and systematic review of colorectal endoscopic mucosal resection.
abstract: OBJECTIVE
  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).
  
  
  CONCLUSIONS
  EMR is an effective technique for the resection of large colorectal polyps and offers an alternative to surgery.
authors.affiliation: Division of Gastroenterology, University of Missouri-Columbia, Columbia, MO 65212, United States of America.
authors.forename: Srinivas R
authors.initials: SR
authors.lastname: Puli
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Kakugawa
authors.forename: Takuji
authors.initials: T
authors.lastname: Gotoda
authors.forename: Daphne
authors.initials: D
authors.lastname: Antillon
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Saito
authors.forename: Mainor R
authors.initials: MR
authors.lastname: Antillon
mesh_terms: D003111:Colonic Polyps / Q000601:surgery*; D015179:Colorectal Neoplasms / Q000601:surgery*; D016099:Endoscopy, Gastrointestinal / Q000706:statistics & numerical data; D005753:Gastric Mucosa / Q000601:surgery*; D006801:Humans; D011230:Precancerous Conditions / Q000601:surgery*