2009
DOI: 10.1245/s10434-009-0520-7
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Successful Complete Cure En-Bloc Resection of Large Nonpedunculated Colonic Polyps by Endoscopic Submucosal Dissection: A Meta-Analysis and Systematic Review

Abstract: ESD should be considered the best minimally invasive endoscopic technique in the treatment of large (>2 cm) sessile and flat polyps because it allows full pathological evaluation and cure in most patients. ESD offers an important alternative to surgery in the therapy of large sessile and flat polyps.

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Cited by 48 publications
(40 citation statements)
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“…Therefore, all colonic lesions C6 mm should be either resected or ablated [4]. From the results of meta-analyses, polypectomy [4] and EMR [6]/ ESD [7] can be considered the preferred less invasive treatments for colorectal neoplasia [8,9]. However, for flat and depressed lesions, endoscopic resection is recommended, since the incidence of carcinoma is even higher in lesions that are B5 mm in size than in polypoid lesions [6,10].…”
Section: Introductionmentioning
confidence: 99%
“…Therefore, all colonic lesions C6 mm should be either resected or ablated [4]. From the results of meta-analyses, polypectomy [4] and EMR [6]/ ESD [7] can be considered the preferred less invasive treatments for colorectal neoplasia [8,9]. However, for flat and depressed lesions, endoscopic resection is recommended, since the incidence of carcinoma is even higher in lesions that are B5 mm in size than in polypoid lesions [6,10].…”
Section: Introductionmentioning
confidence: 99%
“…In the last years, alongside standard snaring techniques, endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD) have been increasingly performed in the resection of larger lesions (50,51). As expected, extending the range of lesions treated endoscopically carries an increased risk of peri-procedural complications such as bleeding and perforation (23, 52).…”
Section: Difficult Colon Polypectomymentioning
confidence: 99%
“…In a meta-analysis including 14 studies, Puli et al [43] concluded that ESD is the best minimally invasive endoscopic technique, and an important alternative to surgery, in the treatment of large (> 2 cm) sessile and flat polyps because it allows full pathological evaluation and cure in most patients. In a match-control study comparing ESD with EMR for treatment of early-stage colorectal tumors, Kobayashi et al [9] showed that colonic ESD achieved a high en-bloc resection rate and a low recurrence rate in short term.…”
Section: Learning Curve For Gastric Esdmentioning
confidence: 99%