Evidence map›Paper›PMID 40086369›Full record

SynthesisClinics (Sao Paulo, Brazil)2025

Comparison of endoscopic submucosal dissection and transanal endoscopic surgery for the treatment of rectal neoplasia: A systematic review and meta-analysis.

Igor Valdeir Gomes de Sousa, Alexandre Moraes Bestetti, Diego Paul Cadena-Aguirre, Angelo So Taa Kum, Paulo Ferreira Mega, Pedro Henrique Veras Ayres da Silva, Nelson Tomio Miyajima, Wanderley Marques Bernardo, Eduardo Guimarães Hourneaux de Moura

Registry-linked trialAbstract readSystematic ReviewMeta-AnalysisComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Clinics (Sao Paulo, Brazil), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06902701 (Endoscopic Submucosal Dissection vs. Transanal Endoscopic Surgery for Rectal Neoplasia), which is not on this map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing 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.

NCT06902701 not yet recruitingnot on this map

Endoscopic Submucosal Dissection vs. Transanal Endoscopic Surgery for Rectal Neoplasia: A Multicenter Prospective Observational Cohort Study

Typeobservational_patient_registrySponsorTurkish Society of Colon and Rectal SurgeryRan2025 to 2028Enrolled156ConditionsRectal NeoplasmsArmsEndoscopic Submucosal Dissection (ESD), Transanal Endoscopic Surgery (TES)
3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Endoscopic mesorectal dissection for precise pathologic staging and potential treatment of locally advanced rectal cancer.VideoGIE : an official video journal of the American Society for Gastrointestinal Endoscopy · 2026
    Article
  3. Article
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

9 authors.

Igor Valdeir Gomes de SousaGastrointestinal Endoscopy Service, Department of Gastroenterology, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil. Electronic address: igor.valdeir@hotmail.com.
Alexandre Moraes BestettiGastrointestinal Endoscopy Service, Department of Gastroenterology, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil.
Diego Paul Cadena-AguirreGastrointestinal Endoscopy Service, Department of Gastroenterology, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil.
Angelo So Taa KumGastrointestinal Endoscopy Service, Department of Gastroenterology, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil.
Paulo Ferreira MegaGastrointestinal Endoscopy Service, Department of Gastroenterology, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil.
Pedro Henrique Veras Ayres da SilvaGastrointestinal Endoscopy Service, Department of Gastroenterology, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil.
Nelson Tomio MiyajimaGastrointestinal Endoscopy Service, Department of Gastroenterology, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil.
Wanderley Marques BernardoGastrointestinal Endoscopy Service, Department of Gastroenterology, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil.
Eduardo Guimarães Hourneaux de MouraGastrointestinal Endoscopy Service, Department of Gastroenterology, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND AND

aimMinimally invasive techniques offer alternatives to conventional surgery in the treatment of early-stage colorectal cancer, reducing morbidity. Transanal Endoscopic Microsurgery (TEM) and Transanal Minimally Invasive Surgery (TAMIS) are widely used, while Endoscopic Submucosal Dissection (ESD) is gaining attention for its ability to achieve complete resection with low recurrence rates. This study compares the efficacy and safety of ESD with Transanal Endoscopic Surgery (TES).

methodsThe authors performed a systematic review and meta-analysis of comparative studies involving patients with endoscopically resectable rectal lesions. Electronic searches were conducted in MEDLINE, EMBASE, Cochrane, and LILACS. Outcomes included recurrence rate, complete resection, en bloc resection, hospital stay, procedure time, and complication rate.

resultsThe analysis included ten observational studies and one Randomized Controlled Trial (RCT) involving 1,094 patients. No significant differences were found in terms of recurrence rate, en bloc resection, R0 resection, and complications between techniques. The RCT showed a shorter procedure time in the TES (RD = 16.6; 95 % CI 8.88 to 24.32; p < 0.0001), whereas observational studies found no significant difference. In addition, observational studies found a shorter hospital stay duration in the ESD (MD = -1.22; 95 % CI -2.11 to -0.33; I

conclusionESD and TES are safe and effective for the treatment of early-stage rectal tumors. Rates of local recurrence, block resection, R0 resection, complications, and procedure time were similar. However, the RCT showed a shorter procedure time with TES, while observational studies showed a shorter hospital stay with ESD.

Indexed as

Endoscopic Mucosal ResectionRectal NeoplasmsTransanal Endoscopic MicrosurgeryTransanal Endoscopic SurgeryHumansLength of StayNeoplasm Recurrence, LocalObservational Studies as TopicOperative TimeRandomized Controlled Trials as TopicTreatment OutcomeEndoscopic submucosal dissectionRectal neoplasmsTransanal endoscopic microsurgeryTransanal minimally invasive surgery

Identifiers

PMID40086369
PMCPMC11957494

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Registered trials

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.