Table 2.
Factors influencing incomplete resection
|
Subgroups
|
IRR % (95%CI)
|
I2
%
|
Studies, n
|
Polyps, n
|
| Resection method, polyps 10–19 mm | ||||
| Hot EMR | 18.5 (8.9–28.1) | 93.2 | 8 | 655 |
| HSP | 16.2 (10.6–21.7) | NA | 2 | 167 |
| U-EMR | 25.5 (18.9–32.2) | NA | 2 | 160 |
| Cold EMR1 | 14.01 (1.8–26.3) | NA | 3 | 334 |
| Resection method, polyps ≥ 20 mm | ||||
| ESD | 12.5 (6.2–18.8) | 95.0 | 9 | 1452 |
| Hot EMR | 29.3 (19.3–39.2) | NA | 3 | 88 |
| Submucosal injection, polyps 10–19 mm | ||||
| No injection | 14.4 (5.4–23.3) | 95.8 | 6 | 836 |
| Injection | 20.0 (11.9–28.0) | 93.9 | 10 | 989 |
| Submucosal injection, polyps ≥ 20 mm | ||||
| No injection | 32.4 (0–76.3) | 96.2 | 3 | 124 |
| Injection | 12.6 (7.7–17.6) | 94.4 | 13 | 1614 |
| Injection solution, polyps ≥ 10 mm | ||||
| Saline solution | 15.8 (7.1–24.6) | 95. 6 | 6 | 774 |
| Hyaluronic acid | 16.3 (8.5–24.1) | 95.1 | 8 | 916 |
| Expert level | ||||
| Only expert endoscopists | 7.0 (3.5, 10.4) | 93. 7 | 8 | 1451 |
| Including non-expert endoscopists | 20.3 (13.5–27.1) | 96.0 | 13 | 2092 |
| Method of margin evaluation, polyps 10–19 mm | ||||
| Margin assessment | 18.6 (10.9, 26.2) | 75.1 | 5 | 380 |
| Margin biopsy | 5.7 (1.1, 10.3) | 95.1 | 5 | 1150 |
| Method of margin evaluation, polyps ≥ 20 mm | ||||
| Margin assessment | 21.8 (9.4–34.2) | 92.1 | 4 | 429 |
| Margin assessment and en bloc resection | 14.1 (5.7–22.6) | 96.0 | 7 | 1106 |
| Margin biopsy | 0.4 (0–2.5) | 55.8 | 3 | 203 |
1
Data exhibit high variance; calculated mean should be handled with care.
NA: Number of studies insufficient for estimation; EMR: Endoscopic mucosal resection; ESD: Endoscopic submucosal dissection; HSP: Hot snare polypectomy; IRR: Incomplete resection rate; U-EMR: Underwater endoscopic mucosal resection.