title: Efficacy and adverse events of EMR and endoscopic submucosal dissection for the treatment of colon neoplasms: a meta-analysis of studies comparing EMR and endoscopic submucosal dissection.
abstract: BACKGROUND
  EMR and endoscopic submucosal dissection (ESD) are used frequently to remove colon neoplasms. However, the predominance of these procedures has not yet been thoroughly explored.
  
  
  OBJECTIVE
  To compare the efficacy and adverse events related to EMR with those related to ESD for colon neoplasms.
  
  
  METHODS
  A meta-analysis of 8 studies published between 2005 and 2013.
  
  
  METHODS
  Multicenter review.
  
  
  METHODS
  Patients from 8 studies yielding 2299 lesions.
  
  
  METHODS
  EMR or ESD.
  
  
  METHODS
  En bloc resection, curative resection, recurrence, and adverse events.
  
  
  RESULTS
  The pooled odds ratios (OR) (OR [95% confidence interval]) for the tumor size, length of the procedure, en bloc resection, curative resection, recurrence, additional surgery, delayed bleeding, and perforation by ESD versus EMR were 7.38 (6.42-8.34), 58.07 (36.27-79.88), 6.84 (3.30-14.18), 4.26 (3.77-6.57), 0.08 (0.04-0.17), 2.16 (1.16-4.03), 0.85 (0.45-1.60), and 4.96 (2.79-8.85), respectively.
  
  
  CONCLUSIONS
  This analysis included only nonrandomized studies.
  
  
  CONCLUSIONS
  The size of the tumor and rate of en bloc resection and curative resection were higher, and the rate of recurrence was lower in the ESD group versus the EMR group. However, in the ESD group, the procedure was longer, and the rate of additional surgery and perforation was higher, suggesting that the indications for ESD should therefore be rigorously determined in order to avoid such problems.
authors.affiliation: Division of Gastroenterology and Hematology/Oncology, Department of Medicine, Asahikawa Medical University, Asahikawa, Hokkaido, Japan.
authors.forename: Mikihiro
authors.initials: M
authors.lastname: Fujiya
authors.affiliation: Division of Gastroenterology and Hematology/Oncology, Department of Medicine, Asahikawa Medical University, Asahikawa, Hokkaido, Japan.
authors.forename: Kazuyuki
authors.initials: K
authors.lastname: Tanaka
authors.affiliation: Division of Gastroenterology and Hematology/Oncology, Department of Medicine, Asahikawa Medical University, Asahikawa, Hokkaido, Japan.
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Dokoshi
authors.affiliation: Division of Gastroenterology and Hematology/Oncology, Department of Medicine, Asahikawa Medical University, Asahikawa, Hokkaido, Japan.
authors.forename: Motoya
authors.initials: M
authors.lastname: Tominaga
authors.affiliation: Division of Gastroenterology and Hematology/Oncology, Department of Medicine, Asahikawa Medical University, Asahikawa, Hokkaido, Japan.
authors.forename: Nobuhiro
authors.initials: N
authors.lastname: Ueno
authors.affiliation: Division of Gastroenterology and Hematology/Oncology, Department of Medicine, Asahikawa Medical University, Asahikawa, Hokkaido, Japan.
authors.forename: Yuhei
authors.initials: Y
authors.lastname: Inaba
authors.affiliation: Division of Gastroenterology and Hematology/Oncology, Department of Medicine, Asahikawa Medical University, Asahikawa, Hokkaido, Japan.
authors.forename: Takahiro
authors.initials: T
authors.lastname: Ito
authors.affiliation: Division of Gastroenterology and Hematology/Oncology, Department of Medicine, Asahikawa Medical University, Asahikawa, Hokkaido, Japan.
authors.forename: Kentaro
authors.initials: K
authors.lastname: Moriichi
authors.affiliation: Division of Gastroenterology and Hematology/Oncology, Department of Medicine, Asahikawa Medical University, Asahikawa, Hokkaido, Japan.
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Kohgo
mesh_terms: D003110:Colonic Neoplasms / Q000601:surgery*; D003113:Colonoscopy / Q000379:methods*; D004210:Dissection / Q000379:methods*; D006801:Humans; D007413:Intestinal Mucosa / Q000601:surgery*; D009364:Neoplasm Recurrence, Local / Q000209:etiology; D016017:Odds Ratio; D011183:Postoperative Complications / Q000209:etiology; D016896:Treatment Outcome