Evidence map›Paper›PMID 37626237›Full record

Observational studySurgical endoscopy2023

Cap-assisted endoscopic mucosal resection as a salvage technique for challenging colorectal laterally spreading tumors.

Andrea Michielan, Federica Crispino, Nicolò de Pretis, Chiara Sartori, Nicola Libertà Decarli, Giovanni de Pretis, Elettra Merola

Abstract readObservational Study
PubMed Publisher
In one paragraph

Observational study in Surgical endoscopy, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Andrea MichielanGastroenterology and Digestive Endoscopy Unit, Department of Surgery, Santa Chiara Hospital, Largo Medaglie D'Oro 9, 38122, Trento, Italy.
Federica CrispinoGastroenterology and Digestive Endoscopy Unit, Department of Surgery, Santa Chiara Hospital, Largo Medaglie D'Oro 9, 38122, Trento, Italy.
Nicolò de PretisGastroenterology and Digestive Endoscopy Unit, Department of Surgery, Santa Chiara Hospital, Largo Medaglie D'Oro 9, 38122, Trento, Italy.
Chiara SartoriSurgical Pathology Unit, Department of Laboratory Medicine, Santa Chiara Hospital, Largo Medaglie D'Oro 9, 38122, Trento, Italy.
Nicola Libertà DecarliSurgical Pathology Unit, Department of Laboratory Medicine, Santa Chiara Hospital, Largo Medaglie D'Oro 9, 38122, Trento, Italy.
Giovanni de PretisGastroenterology and Digestive Endoscopy Unit, Department of Surgery, Santa Chiara Hospital, Largo Medaglie D'Oro 9, 38122, Trento, Italy.
Elettra MerolaGastroenterology and Digestive Endoscopy Unit, Department of Surgery, Santa Chiara Hospital, Largo Medaglie D'Oro 9, 38122, Trento, Italy. elettra.merola@gmail.com.ORCID http://orcid.org/0000-0001-9553-7684

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundCap-assisted endoscopic mucosal resection (EMR-c) has emerged as a potential alternative to standard piecemeal wide-field EMR (WF-EMR) for the resection of laterally spreading tumors (LSTs). However, clear indications for this technique are still lacking. Our objective was to investigate the performance of salvage EMR-c after WF-EMR failure in the resection of large colorectal LSTs.

methodsThe data of consecutive patients undergoing WF-EMR for large colorectal LSTs (2015-2021) were analyzed in this single-center, retrospective, observational study. In the event of a WF-EMR failure, the procedure was switched to EMR-c in the same session. The efficacy of the two techniques was evaluated in terms of complete endoscopic resection, R0 resection, and recurrence rate. Safety was also assessed.

resultsOverall, the data from 81 WF-EMRs were collected. Eighteen cases of WF-EMR failure were switched to EMR-c in the same session and complete endoscopic resection was achieved in 17/18 patients (94.4%). No statistically significant difference was observed between WF-EMR and salvage EMR-c in terms of macroscopic radicality (P = 0.40) and R0 resection (P = 0.12). However, recurrence was more common with EMR-c (44.4% vs. 23.5%; P = 0.05), as were adverse events, particularly intraprocedural bleeding (27.8% vs. 7.9%; P = 0.04).

conclusionEMR-c is an effective salvage technique for challenging colorectal LSTs following WF-EMR failure. Due to the elevated risk of adverse events associated with this procedure, careful patient selection, endoscopic expertise, and close follow-up are strongly recommended.

Indexed as

Colorectal NeoplasmsEndoscopic Mucosal ResectionColonoscopyHumansIntestinal MucosaRetrospective StudiesTreatment OutcomeCapEndoscopic mucosal resectionLaterally spreading tumorsSalvage

Identifiers

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.