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The principal downside of using endoscopic mucosal resection (EMR) versus endoscopic submucosal dissection (ESD) for removal of colorectal lesions is the higher initial recurrence rate.
To estimate the risk for recurrence after EMR of nonpedunculated colorectal lesions, investigators conducted a systematic review and a meta-analysis of 33 studies in which at least 80% of the patients had submucosal injection.
The overall recurrence rate at the initial follow-up was 20% after piecemeal resection versus 3% after en bloc resection. The overwhelming majority of recurrences were visible at the first follow-up procedure, but a small percentage of recurrences were “late” and detectable only at the subsequent follow-up procedure. Successful eradicati…