Endoscopy 2024; 56(S 02): S408-S409
DOI: 10.1055/s-0044-1783720
Abstracts | ESGE Days 2024
ePoster

Cold Endoscopic Mucosal Resection (c-EMR) Of Non-Pedunculated Colorectal Polyps≥20 mm: A Systematic Review And Meta-Analysis

D. Ramai
1   Gastroenterology and Hepatology, University of Utah Health, Salt Lake City, United States of America
,
M. Maida
2   The Hospital "Maddalena Raimondi", San Cataldo, Italy
,
M. Previtera
3   University of Cincinnati, Cincinnati, United States of America
,
O. Brooks
4   University of Connecticut-Stamford Campus, Stamford, United States of America
,
B. Clement
3   University of Cincinnati, Cincinnati, United States of America
,
Y. Wang
5   Trinity Health of New England Medical Group: Springfield, Springfield, United States of America
,
S. Chandan
6   CHI Health Creighton University Medical Center, Omaha, United States of America
,
B. Dhindsa
7   NYU Langone Health, New York, United States of America
,
F. Antonio
8   Università degli studi di Foggia, Foggia, Italy
,
M. A. Khashab
9   Johns Hopkins University, Baltimore, United States of America
,
A. Ofosu
10   Division of Digestive Diseases, University of Cincinnati, Cincinnati, United States of America
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Aims There is increasing evidence that cold EMR (c-EMR) can effectively treat large colorectal polyps. We aim to appraise the current literature and evaluate outcomes following c-EMR for non-pedunculated colonic polyps≥20 mm.

Methods Major databases were searched. Primary outcomes included recurrence rate and adverse events. Meta-analysis was performed using a random effects model.

Results Nine articles were included in the final analysis which included 817 patients and 1,077 colorectal polyps. Average polyp size was 28.8 (±5.1) mm. Pooled recurrence rate of polyps of any histology at 4 to 6 months was 21.0% (95% C 9.0% – 32.0%, P<0.001, I2=97.3, P<0.001). Subgroup analysis showed that recurrence was 10% for proximal lesions (95% CI 0.0% – 20.0%, P=0.054, I2=93.7%, P=0.054) and 9% for distal lesions (95% CI 2.0% – 21.0%, P=0.114, I2=95.8%, P=0.114). Furthermore, subgroup analysis showed that recurrence was 12% for adenoma (95% CI 4.0% – 19.0%, P=0.003, I2=98.0%, P=0.003), and 3% for sessile serrated polyps (SSP) (95% CI 1.0% – 5.0%, P=0.002, I2=34.4%, P=0.002). Post-polypectomy bleeding occurred in 1% (n=8/817) of patients while abdominal pain occurred in 0.2% (n=2/817) of patients.

Conclusions C-EMR for non-pedunculated colorectal polyps≥20 mm show an excellent safety profile with a very low rate of delayed bleeding as well as significantly less recurrence for SSP than adenomas.



Publication History

Article published online:
15 April 2024

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