IDDF2021-ABS-0119 Thermal ablation of mucosal defect margins after endoscopic mucosal resection reduces adenoma recurrence: a systematic review and meta-analysis

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Pubblicato in:Gut vol. 70, no. Suppl 2 (Sep 2021), p. A126
Autore principale: Nikko Theodore Raymundo
Altri autori: Joseph Erwin Dumagpi, Lin, Tim, Co, Jonard
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BMJ Publishing Group LTD
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Abstract:BackgroundResection of colorectal lesions larger than 20mm is complex and requires advanced endoscopic techniques such as endoscopic mucosal resection (EMR). Adenoma recurrence is a limiting factor especially due to micro-adenomas at the margin of the EMR mucosal defect site. This systematic review and meta-analysis aimed to determine the efficacy of thermal ablation of mucosal defect margins after EMR in reducing adenoma recurrence.MethodsA comprehensive, computerized literature search from the PubMed Central, Embase, Cochrane Library, and OVID was performed with the following search terms: coagulation, mucosal defect margin, endoscopic mucosal resection, and adenoma recurrence. Three cohort studies were selected and validated using the Newcastle-Ottawa criteria. Pooled data were combined under a random-effects model. The Cochrane Review Manager Software version 5.3 was used for all analyses.ResultsThree cohort studies comprising of 361 patients were analyzed. In the random-effects model, the pooled odds ratio (OR) of adenoma recurrence was 0.22 (95% CI 0.13-0.39; I2 = 0%)( IDDF2021-ABS-0119. <xref ref-type="fig" rid="F1">Figure 1). The pooled data of the three studies showed a trend towards a beneficial effect of thermal ablation of mucosal defect post-endoscopic mucosal resection in reducing the risk of adenoma recurrence.Abstract IDDF2021-ABS-0119 Figure 1Forrest plot[Figure omitted. See PDF]ConclusionsThermal ablation of the mucosal defect margins was shown to have a decreased risk of adenoma recurrence after endoscopic mucosal resection. However, further prospective randomized studies are recommended to confirm this relationship.
ISSN:0017-5749
1468-3288
DOI:10.1136/gutjnl-2021-IDDF.143
Fonte:Science Database