Endoscopy
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See the full rubric →Endoscopic submucosal dissection versus transanal endoscopic surgery in rectal neoplasms: Meta-analysis of randomized controlled trials and trial sequential analysis.
Clinical takeawayBoth ESD and TES remain acceptable organ-preserving options for selected rectal neoplasms with no significant differences in resection and oncologic outcomes; however, certainty of evidence is very low for these outcomes. TES was faster by 21.93 minutes. Safety outcomes were also not significantly different but remain inconclusive (trial sequential analysis). Choose technique based on lesion characteristics, local expertise, and existing proficiency rather than evidence of superiority from this comparison.
What it foundNo significant differences between TES and ESD in en bloc resection (RR 1.02, 95% CI 0.95-1.10), R0 resection (RR 1.00, 95% CI 0.90-1.10), recurrence (RR 1.73, 95% CI 0.53-5.67), bleeding, or perforation; TES was faster by 21.93 minutes (95% CI -28.22 to -15.64). Trial sequential analysis found evidence inconclusive for bleeding, perforation, and recurrence.
ContextBoth ESD and TES are established organ-preserving approaches for rectal neoplasms, but direct comparative data from RCTs was limited. This meta-analysis provides the first systematic comparison and suggests neither technique has a clear oncologic advantage in selected patients.
No standard claimed for this paper
Every paper is compared to the standard governing its question. This one is not: either no standard in the corpus matches it, or the comparison did not hold up on review and was withdrawn rather than published unverified. Both are logged.
Saeed A … Hayat M · Endoscopy · IF 11.8 · PubMed ↗