Abstract
Background and Aims
Underwater endoscopic mucosal resection (UEMR) is an emerging technique for endoscopic
resection of superficial non-ampullary duodenal epithelial tumors (SNADETs). However,
compared to conventional EMR, its efficacy and safety has not been widely explored.
Methods
We conducted a comprehensive search using the Pubmed, Embase, and Cochrane Library
databases to identify studies comparing the efficacy and safety of UEMR versus EMR
for SNADETs. The main outcomes examined included en bloc resection rate, R0 resection
rate, recurrence rate, procedure time, and adverse events.
Results
A total of 5 studies comprising 635 patients were included. All the literature included
duodenal lesions smaller than 20 mm. The pooled analysis showed that UEMR could achieve
a higher en bloc resection rate (OR 1.78, 95%CI: 1.17 to 2.71, P = 0.007) and shorter procedure time (MD -4.08, 95%CI: -6.44 to -1.73, P = 0.0007) than EMR. However, the pooled results did not support a superiority of
UEMR over EMR for R0 resection rate (OR 1.27; 95% CI: 0.90 to 1.81, P = 0.18) or recurrence rate (OR 0.49; 95% CI: 0.15 to 1.67, P = 0.26). The occurrence of adverse events, including postoperative bleeding, intraoperative
perforation, and delayed perforation, was very low in included studies.
Conclusion
Compared to EMR, UEMR is an effective and safe technique for SNADETs ≤20 mm.
Keywords
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Article info
Publication history
Published online: October 01, 2022
Accepted:
September 7,
2022
Received:
December 17,
2021
Editor: Roberto de FranchisPublication stage
In Press Corrected ProofIdentification
Copyright
© 2022 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.
