Conventional Versus Traction Endoscopic Submucosal Dissection for Colorectal Tumors: A Meta-analysis of Randomized...

Area of Science:

• Gastroenterology
• Endoscopic Surgery
• Oncology

Background:

• Conventional endoscopic submucosal dissection (C-ESD) is a standard technique for colorectal lesions.
• Traction endoscopic submucosal dissection (T-ESD) aims to improve lesion stabilization and ease of dissection.
• Conflicting results exist regarding the clinical outcomes of T-ESD versus C-ESD.

Purpose of the Study:

• To conduct a meta-analysis comparing T-ESD and C-ESD for colorectal tumors.
• To evaluate differences in procedure time, resection speed, and key resection outcomes.
• To assess the safety profiles of both endoscopic dissection techniques.

Main Methods:

• A systematic search of multiple databases for relevant randomized controlled trials (RCTs).
• Inclusion of six RCTs with a total of 566 patients (284 C-ESD, 282 T-ESD).
• Meta-analysis using a random-effects model to compare procedure time, resection speed, R0 resection, en bloc resection, delayed bleeding, and perforation.

Main Results:

• T-ESD was associated with significantly shorter procedure times (SMD 0.91) and faster resection speeds (SMD -1.03) compared to C-ESD.
• No significant differences were observed between T-ESD and C-ESD in R0 resection rates (RR 1.00), en bloc resection (RR 0.99), delayed bleeding (RR 0.66), or perforation (RR 2.16).

Conclusions:

• T-ESD significantly reduces procedure time and increases resection speed for colorectal lesions compared to C-ESD.
• The clinical outcomes and safety profiles of T-ESD and C-ESD are comparable.
• T-ESD represents a potentially more efficient alternative to C-ESD without compromising oncological or safety endpoints.