Recurrence rates after endoscopic resection of large colorectal polyps: A systematic review and meta-analysis
Carola Rotermund, Roupen Djinbachian, Mahsa Taghiakbari, Markus D. Enderle, Axel Eickhoff, Daniel von Renteln
Abstract
BACKGROUND: traditional hot snare polypectomy and standard EMR remains unclear. AIM: To analyze LRR of large colonic polyps in a systematic review and meta-analysis. METHODS: MEDLINE, EMBASE, EBM Reviews, and CINAHL were searched for prospective studies reporting LRR or incomplete resection rate (IRR) after colonic polypectomy of polyps ≥ 10 mm, published between January 2011 and July 2021. Primary outcome was LRR for polyps ≥ 10 mm. RESULTS: standard EMR without (15.2%; 95%CI, 12.5%-18.0%; 4 studies, 650 polyps) or with unsystematic margin ablation (16.5%; 95%CI, 15.2%-17.8%; 6 studies, 3031 polyps). CONCLUSION: LRR is significantly lower after ESD or EMR with routine margin ablation; thus, these techniques should be considered standard for endoscopic removal of large colorectal polyps. Other techniques, such as CSP, cold EMR, and underwater EMR require further evaluation in prospective studies before their routine implementation in clinical practice can be recommended.