The following is a summary of “Tip-in Versus Conventional Endoscopic Mucosal Resection for Colorectal Neoplasia A Systematic Review and Meta-analysis,” published in the November 2023 issue of Gastroenterology by Niu, et al.
Gastrointestinal neoplasms in their early stages are commonly addressed through conventional endoscopic mucosal resection (C-EMR). However, C-EMR often falls short of complete resection, particularly with sizable colorectal lesions. The advent of Tip-in endoscopic mucosal resection (EMR), designed to enhance en bloc resection and minimize procedural slippage, represents a recent advancement in the field.
The systematic review and meta-analysis scrutinized published studies comparing Tip-in EMR to conventional EMR. Our search across electronic databases yielded 11 relevant studies, encompassing 1,244 lesions (684 in Tip-in EMR, 560 in C-EMR). The meta-analysis demonstrated a significant improvement with Tip-in EMR, showcasing a higher en bloc resection rate (OR=3.61; 95% CI, 2.09-6.23; P<0.00001; I2=0%) and a superior complete resection rate (OR=2.49; 95% CI, 1.65-3.76; P<0.0001; I2=0%) compared to conventional EMR. Interestingly, the two groups had no notable differences in procedure time and rates of procedure-related complications (including perforation and delayed bleeding rate).
Tip-in EMR exhibited superior performance over C-EMR in achieving both en bloc and complete resection of colorectal lesions, with comparable rates of procedural complications. The findings underscored the potential of Tip-in EMR as an effective alternative for enhancing the management of colorectal neoplasia.
Source: journals.lww.com/jcge/abstract/2023/11000/tip_in_versus_conventional_endoscopic_mucosal.4.aspx
