Clinical Endoscopy

Systematic Review and Meta-analysises

Efficacy and safety of endoscopic submucosal dissection for colorectal dysplasia in patients with inflammatory bowel disease: a systematic review and meta-analysis: Talia F. Malik, Vaishnavi Sabesan, Babu P. Mohan, Asad Ur Rahman, Mohamed O. Othman, Peter V. Draganov, Gursimran S. Kochhar; Clin Endosc 2024;57(3):317-328. Published online February 29, 2024; DOI: https://doi.org/10.5946/ce.2023.205

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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.

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
Endoscopic submucosal dissection for visible dysplasia in inflammatory bowel disease: a nationwide multicenter cohort from the GETAID and the SFED
Sophie Geyl, Jérémie Jacques, Alicia Anneraud, Stanislas Chaussade, Vered Abitbol, Jean Baptiste Chevaux, Laurent Peyrin-biroulet, Clara Yzet, Mathieu Pioche, Arthur Berger, David Laharie, Stéphane Koch, Sarah Leblanc, Mélanie Serrero, Marc Barthet, Jean
Journal of Crohn's and Colitis.2025;[Epub] CrossRef
The 2024 top 10 list of endoscopy topics in medical publishing: an annual review by the American Society for Gastrointestinal Endoscopy Editorial Board
Melissa Martinez, Michael J. Bartel, Tiffany Chua, Lara Dakhoul, Hala Fatima, Brooke Glessing, Dennis Jensen, Luis F. Lara, Brianna Shinn, Micheal Tadros, Edward Villa, John R. Saltzman
Gastrointestinal Endoscopy.2025; 102(1): 2. CrossRef

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Stricturing Crohn's disease: what is the role of endoscopic stenting? A systematic review: Giorgia Burrelli Scotti, Roberto Lorenzetti, Annalisa Aratari, Antonietta Lamazza, Enrico Fiori, Claudio Papi, Stefano Festa; Clin Endosc 2023;56(6):726-734. Published online October 24, 2023; DOI: https://doi.org/10.5946/ce.2023.059

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Background
/Aims: Endoscopic stenting for stricturing Crohn's disease (CD) is an emerging treatment that achieves more persistent dilatation of the stricture over time than endoscopic balloon dilatation (EBD). We aimed to explore the efficacy and safety of stenting for the treatment of CD strictures.
Methods
A systematic electronic literature search was performed (PROSPERO; no. CRD42022308033). The primary outcomes were technical success, efficacy, complication rate, and the need for further interventions due to reobstruction. The outcomes of partially covered self-expanding metal stents (PCSEMS) with scheduled retrieval after seven days were also analyzed.
Results
Eleven eligible studies were included in the review. Overall, 173 patients with CD were included in this study. Mean percentage of technical success was 95% (range, 80%–100%), short-term efficacy was 100% in all studies, and long-term efficacy was 56% (range, 25%–90%). In patients with a scheduled PCSEMS retrieval, the long-term efficacy was 76% (range, 59%–90%), the mean complication rate was 35% (range, 15%–57%), and the major complication rate was 11% (range, 0%–29%).
Conclusions
Endoscopic stenting with scheduled PCSEMS retrieval may be considered a feasible second-line treatment for short CD strictures to postpone surgery. However, larger head-to-head prospective studies are needed to understand the role of stenting as an alternative or additional treatment to EBD in CD.

Citations

Citations to this article as recorded by

Role of Endoscopy in Inflammatory Bowel Disease: What Every Gastroenterologist Should Know
Gursimran S. Kochhar, Claudia Dziegielewski, Jason N. Schairer, Raymond K. Cross
American Journal of Gastroenterology.2025;[Epub] CrossRef
Perioperative Considerations for the Surgical Treatment of Crohn’s Disease with Discussion on Surgical Antibiotics Practices and Impact on the Gut Microbiome
Shelbi Olson, Lindsay Welton, Cyrus Jahansouz
Antibiotics.2024; 13(4): 317. CrossRef

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203 Download
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Reviews

Current status of image-enhanced endoscopy in inflammatory bowel disease: Young Joo Yang; Clin Endosc 2023;56(5):563-577. Published online September 26, 2023; DOI: https://doi.org/10.5946/ce.2023.070

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