Surgical or Endoscopic Resection for Large Rectal Polyps?

When large sessile polyps are encountered in the rectum, resection options in Western countries typically include piecemeal polypectomy (endoscopic mucosal resection, or EMR) and transanal surgical resection (transanal endoscopic microsurgery, or TEM). The two techniques have not been compared directly, and the decision on which method to use might depend on local expertise.

To examine available evidence on the success and complication rates of the two approaches to removing large (>2 cm) rectal polyps, investigators conducted a systematic review of 68 studies, including 5 randomized controlled trials, 30 prospective studies, 23 retrospective studies, and 10 of indeterminate type. The randomized trials did not directly compare EMR and TEM bu…