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Efficacy and safety of endoscopic submucosal dissection for colorectal dysplasia in patients with inflammatory bowel disease: a systematic review and meta-analysis
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Talia F. Malik, Vaishnavi Sabesan, Babu P. Mohan, Asad Ur Rahman, Mohamed O. Othman, Peter V. Draganov, Gursimran S. Kochhar
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Clin Endosc 2024;57(3):317-328. Published online February 29, 2024
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DOI: https://doi.org/10.5946/ce.2023.205
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 Abstract
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 - Background
/Aims: In this meta-analysis, we studied the safety and efficacy of endoscopic submucosal dissection (ESD) for colorectal dysplasia in patients with inflammatory bowel disease (IBD).
Methods
Multiple databases were searched, and studies were retrieved based on pre-specified criteria until October 2022. The outcomes assessed were resection rates, procedural complications, local recurrence, metachronous tumors, and the need for surgery after ESD in IBD. Standard meta-analysis methods were followed using the random-effects model, and I2% was used to assess heterogeneity.
Results
Twelve studies comprising 291 dysplastic lesions in 274 patients were included with a median follow-up of 25 months. The pooled en-bloc resection, R0 resection, and curative resection rates were 92.5% (95% confidence interval [CI], 87.9%–95.4%; I2=0%), 81.5% (95% CI, 72.5%–88%; I2=43%), and 48.9% (95% CI, 32.1%–65.9%; I2=87%), respectively. The local recurrence rate was 3.9% (95% CI, 2%–7.5%; I2=0%). The pooled rates of bleeding and perforation were 7.7% (95% CI, 4.5%–13%; I2=10%) and 5.3% (95% CI, 3.1%–8.9%; I2=0%), respectively. The rates of metachronous recurrence and additional surgery following ESD were 10% (95% CI, 5.2%–18.2%; I2=55%) and 13% (95% CI, 8.5%–19.3%; I2=54%), respectively.
Conclusions
ESD is safe and effective for the resection of dysplastic lesions in IBD with an excellent pooled rate of en-bloc and R0 resection.
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Citations
Citations to this article as recorded by  - Molecular Mechanisms and Clinical Aspects of Colitis-Associated Cancer in Ulcerative Colitis
Jesus K. Yamamoto-Furusho, Fausto D. Gutierrez-Herrera
Cells.2025; 14(3): 162. CrossRef - Colitis-Associated Dysplasia in Inflammatory Bowel Disease: Features and Endoscopic Management
Sara C. Schiavone, Livia Biancone, Mariasofia Fiorillo, Andrea Divizia, Roberto Mancone, Benedetto Neri
Cancers.2025; 17(5): 784. CrossRef - Effect of perioperative enteral nutrition on immune and nutritional status of patients with gastric cancer after endoscopic submucosal dissection
Shu-Yuan Zhu, Hai-Ping Shen
World Chinese Journal of Digestology.2025; 33(4): 291. CrossRef - Effect of perioperative enteral nutrition on immune and nutritional status of patients with gastric cancer after endoscopic submucosal dissection
Shu-Yuan Zhu, Hai-Ping Shen
World Chinese Journal of Digestology.2025; 33(4): 284. CrossRef
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