Cold Endoscopic Mucosal Resection (c-EMR) of Nonpedunculated Colorectal Polyps ≥20 mm: A Systematic Review and...

Area of Science:

• Gastroenterology
• Endoscopic Procedures
• Colorectal Cancer Prevention

Background:

• Large colorectal polyps (≥20 mm) present a therapeutic challenge.
• Cold endoscopic mucosal resection (c-EMR) is emerging as a viable treatment option.
• Evaluating c-EMR outcomes for nonpedunculated polyps is crucial.

Approach:

• Systematic literature review and meta-analysis.
• Inclusion of nine studies with 817 patients and 1077 polyps.
• Random-effects model to assess recurrence and adverse events.

Key Points:

• Pooled recurrence rate was 21.0% for all polyp types.
• Recurrence rates varied by histology: 12% for adenomas, 3% for sessile serrated polyps.
• Adverse events were low: 1% post-polypectomy bleeding, 0.2% abdominal pain.

Conclusions:

• C-EMR demonstrates an excellent safety profile for large nonpedunculated colorectal polyps.
• Sessile serrated polyps exhibit significantly lower recurrence rates post-c-EMR compared to adenomas.
• C-EMR is a safe and effective endoscopic treatment for large colorectal polyps.