Evidence map›Paper›PMID 42315779›Full record

SynthesisSurgical endoscopy2026

Recurrence rates following endoscopic mucosal resection versus endoscopic submucosal dissection for colorectal polyps: a systematic review and meta-analysis of randomized controlled trials.

Tomoyuki Nishimura, Kareem Khalaf, Mohamed Abdulla Ghuloom Abdulla Bucheeri, Huaqi Li, Yuhong Yuan, Natalia Causada Calo, Gary May, Jeffrey D Mosko, Christopher W Teshima

Abstract readSystematic ReviewMeta-AnalysisComparative Study
PubMed Publisher
In one paragraph

Synthesis in Surgical endoscopy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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.

Tomoyuki NishimuraDivision of Gastroenterology, St. Michael's Hospital, University of Toronto, Toronto, ON, Canada.
Kareem KhalafDivision of Gastroenterology, St. Michael's Hospital, University of Toronto, Toronto, ON, Canada.
Mohamed Abdulla Ghuloom Abdulla BucheeriDivision of Gastroenterology, St. Michael's Hospital, University of Toronto, Toronto, ON, Canada.
Huaqi LiDivision of Gastroenterology, St. Michael's Hospital, University of Toronto, Toronto, ON, Canada.
Yuhong YuanDivision of Gastroenterology, Department of Medicine, McMaster University, Hamilton, ON, Canada.
Natalia Causada CaloDivision of Gastroenterology, St. Michael's Hospital, University of Toronto, Toronto, ON, Canada.
Gary MayDivision of Gastroenterology, St. Michael's Hospital, University of Toronto, Toronto, ON, Canada.
Jeffrey D MoskoDivision of Gastroenterology, St. Michael's Hospital, University of Toronto, Toronto, ON, Canada.
Christopher W TeshimaDivision of Gastroenterology, St. Michael's Hospital, University of Toronto, Toronto, ON, Canada. christopher.teshima@utoronto.ca.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND AND

aimsEndoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD) are widely used for resecting large, laterally spreading colorectal polyps. While ESD offers higher en bloc resection rates, its comparative efficacy and safety relative to EMR remain uncertain, particularly in Western practice. This systematic review and meta-analysis aimed to evaluate the recurrence and adverse event rates of EMR versus ESD in adult patients with colorectal polyps  ≥ 20 mm.

methodsWe conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) comparing EMR and ESD for colorectal polyps. Ovid MEDLINE and Embase were searched from inception to April 2024. The primary outcome was recurrence rate; secondary outcomes included total adverse events, bleeding, and perforation. Certainty of evidence was assessed using the GRADE framework.

resultsIn this meta-analysis of three randomized controlled trials including 484 patients, ESD was associated with significantly lower recurrence rates compared to EMR (OR 3.24, 95% CI: 1.58-6.64), with high certainty of evidence. There were no significant differences between EMR and ESD in total adverse events (OR 0.96, 95% CI: 0.43-2.17), bleeding (OR 0.96, 95% CI: 0.41-2.27), or perforation rates (OR 0.96, 95% CI: 0.14-6.65), though certainty for these outcomes was moderate due to heterogeneity and imprecision.

conclusionESD is associated with significantly lower recurrence rates compared to EMR in the treatment of large colorectal polyps, with high-certainty evidence. These findings support the use of ESD when recurrence risk is a primary concern, while EMR remains a feasible alternative with comparable safety. PROSPERO: CRD420251048732.

Indexed as

Colonic PolypsColonoscopyEndoscopic Mucosal ResectionNeoplasm Recurrence, LocalHumansRandomized Controlled Trials as TopicColorectal polypsEn bloc resectionEndoscopic mucosal resectionEndoscopic submucosal dissectionRandomized controlled trialsRecurrence

Identifiers

PMID42315779

What OpenQuestion holds

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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.