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| http://dx.doi.org/10.1055/a-2050-7431 | DOI Listing |
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Thermal ablation of margins for recurrence prevention after endoscopic mucosal resection: a systematic review and meta-analysis.
Surg Endosc
January 2025
Fundación Barceló, Instituto Universitario de Ciencias de la Salud, Buenos Aires, Argentina.
Background And Aims: Endoscopic mucosal resection (EMR) of large colorectal lesions can be challenging, and residual lesions after EMR can progress to colorectal cancer. We aimed to assess the efficacy and safety of adding thermal ablation of margins [using argon plasma coagulation (APC) or snare tip soft coagulation (STSC)] in reducing recurrence rates after EMR.
Methods: We performed a systematic review and meta-analysis of randomized controlled trials (RCTs) identified from PubMed, Cochrane Library, and Embase.
Colorectal polypectomy and endoscopic mucosal resection: European Society of Gastrointestinal Endoscopy (ESGE) Guideline - Update 2024.
Endoscopy
July 2024
Department of Gastroenterology and Hepatology, Westmead Hospital, Sydney, Australia.
1: ESGE recommends cold snare polypectomy (CSP), to include a clear margin of normal tissue (1-2 mm) surrounding the polyp, for the removal of diminutive polyps (≤ 5 mm).Strong recommendation, high quality of evidence. 2: ESGE recommends against the use of cold biopsy forceps excision because of its high rate of incomplete resection.
View Article and Find Full Text PDFEfficacy and Safety of Thermal Ablation after Endoscopic Mucosal Resection: A Systematic Review and Network Meta-Analysis.
J Clin Med
February 2024
Division of Gastroenterology and Hepatology, Bon Secours Mercy Health, Toledo, OH 43608, USA.
(1) : Large colonic polyps during colonoscopy can be managed by Endoscopic mucosal resection (EMR). To decrease the polyp recurrence rate, thermal ablation methods like argon plasma coagulation (APC) and snare tip soft coagulation (STSC) have been introduced. We performed this network meta-analysis to assess the efficacy and safety of these modalities.
View Article and Find Full Text PDFRecurrences of advanced sessile and lateral spreading colorectal adenoma after endoscopic mucosal resection (EMR) thermal ablation versus no adjuvant therapy (RESPECT): a protocol of an international randomized controlled trial.
Trials
February 2024
Department of Gastroenterology and Hepatology, Radboud University Medical Center, Radboud Institute for Health Sciences, 6500 HB, Nijmegen, The Netherlands.
Background: Nowadays, large benign lateral spreading lesions (LSLs) and sessile polyps in the colorectum are mostly resected by endoscopic mucosal resection (EMR). A major drawback of EMR is the polyp recurrence rate of up to 20%. Snare tip soft coagulation (STSC) is considered an effective technique to reduce recurrence rates.
View Article and Find Full Text PDFAnalyzing methods for reducing recurrence rates after EMR of large nonpedunculated colorectal polyps: an indirect pairwise comparison.
Gastrointest Endosc
March 2024
Division of Gastroenterology, Department of Internal Medicine, University of Kansas-School of Medicine, Kansas City, Kansas, USA; Kansas City VA Medical Center, Kansas City, Missouri, USA.
Background And Aims: Despite advances in EMR techniques, a high polyp recurrence rate remains a challenge. Due to the scarcity of direct comparisons, we performed an indirect comparison of conventional EMR (EMR alone), underwater EMR (U-EMR), and EMR + adjuvant thermal ablation of polypectomy margins to assess polyp recurrence rates.
Methods: Electronic databases were searched from inception to January 12, 2023, for studies reporting polyp recurrence rates after EMR for large nonpedunculated polyps (>15 mm) with or without adjuvant techniques (snare tip soft coagulation [STSC]/argon plasma coagulation [APC]).
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