Comparing endoscopic mucosal resection with endoscopic submucosal dissection: the different endoscopic techniques for colorectal tumors

Abstract Background Endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD) are used for the removal of colorectal tumors. There are no current guidelines or consensus on the optimal treatment strategy for these lesions. A meta-analysis was conducted to compare the effectiveness and safety of ESD and EMR for colorectal tumors. Methods For the years 1966 until October 2014, Medline, PubMed, Scopus, Web of Science, and Cochrane Central Register of Controlled Trials were searched for articles comparing the effectiveness and safety of ESD and EMR. STATA 11.0 and RevMan 5.0 were used for meta-analysis and publication bias. Results Seventeen articles were included in this meta-analysis. ESD was more effective than EMR in endoscopic complete resection rate (odds ratio [OR] = 2.81; 95% confidence interval [CI], 1.39–5.70; Z = 2.86; P = 0.004) and pathologic complete resection rate (OR = 2.81; 95% CI, 1.39–5.70; Z = 2.86; P = 0.004). ESD resulted in a higher perforation rate (OR = 5.27; 95% CI, 2.75–10.08; Z = 5.01; P