title: Endoscopic submucosal dissection vs endoscopic mucosal resection for colorectal tumors: a meta-analysis.
abstract: OBJECTIVE
  To compare the efficacy and safety of endoscopic submucosal dissection (ESD) and endoscopic mucosal resection (EMR) for the treatment of colorectal tumors.
  
  
  METHODS
  Databases, such as PubMed, EMBASE, Cochrane Library and Science Citation Index updated to 2013 were searched to include eligible articles. In the meta-analysis, the main outcome measurements were the en bloc resection rate, the histological resection rate and the local recurrence rate. Meanwhile, we also compared the operation time and the incidence of procedure-related complications.
  
  
  RESULTS
  Six trials were identified and a total of 1642 lesions were included. The en bloc resection rate was higher and the local recurrence rate was lower in the ESD group compared with the EMR group (OR = 7.94; 95%CI: 3.96-15.91; OR = 0.09; 95%CI: 0.04-0.19). There was no significant difference in histological resection rate(OR = 1.65; 95%CI: 0.29-9.30) and procedure-related complication rate between the two groups (OR = 1.59; 95%CI: 0.92-2.73). The meta-analysis also showed that ESD was more time consuming than EMR.
  
  
  CONCLUSIONS
  Compared with EMR, ESD results in higher en bloc resection rate and lower local recurrence rate for the treatment of colorectal tumors, without increasing the procedure-related complications.
authors.affiliation: Jing Wang, Xiao-Hua Zhang, Jian Ge, Chong-Mei Yang, Ji-Yong Liu, Shu-Lei Zhao, Department of Gastroenterology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan 250021, Shandong Province, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Wang
authors.affiliation: Jing Wang, Xiao-Hua Zhang, Jian Ge, Chong-Mei Yang, Ji-Yong Liu, Shu-Lei Zhao, Department of Gastroenterology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan 250021, Shandong Province, China.
authors.forename: Xiao-Hua
authors.initials: XH
authors.lastname: Zhang
authors.affiliation: Jing Wang, Xiao-Hua Zhang, Jian Ge, Chong-Mei Yang, Ji-Yong Liu, Shu-Lei Zhao, Department of Gastroenterology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan 250021, Shandong Province, China.
authors.forename: Jian
authors.initials: J
authors.lastname: Ge
authors.affiliation: Jing Wang, Xiao-Hua Zhang, Jian Ge, Chong-Mei Yang, Ji-Yong Liu, Shu-Lei Zhao, Department of Gastroenterology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan 250021, Shandong Province, China.
authors.forename: Chong-Mei
authors.initials: CM
authors.lastname: Yang
authors.affiliation: Jing Wang, Xiao-Hua Zhang, Jian Ge, Chong-Mei Yang, Ji-Yong Liu, Shu-Lei Zhao, Department of Gastroenterology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan 250021, Shandong Province, China.
authors.forename: Ji-Yong
authors.initials: JY
authors.lastname: Liu
authors.affiliation: Jing Wang, Xiao-Hua Zhang, Jian Ge, Chong-Mei Yang, Ji-Yong Liu, Shu-Lei Zhao, Department of Gastroenterology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan 250021, Shandong Province, China.
authors.forename: Shu-Lei
authors.initials: SL
authors.lastname: Zhao
mesh_terms: D016009:Chi-Square Distribution; D003082:Colectomy / Q000009:adverse effects / Q000379:methods*; D003106:Colon / Q000473:pathology / Q000601:surgery*; D003113:Colonoscopy / Q000009:adverse effects; D015179:Colorectal Neoplasms / Q000473:pathology / Q000601:surgery*; D004210:Dissection / Q000009:adverse effects; D006801:Humans; D007413:Intestinal Mucosa / Q000473:pathology / Q000601:surgery*; D009364:Neoplasm Recurrence, Local; D016017:Odds Ratio; D061646:Operative Time; D011183:Postoperative Complications / Q000209:etiology; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
keywords: Colorectal tumors; Complication; En bloc resection; Endoscopic mucosal resection; Endoscopic submucosal dissection; Histological resection; Local recurrence