Endoscopic full-thickness resection versus endoscopic submucosal dissection for colorectal lesions: a systematic review and meta-analysis.

Authors

Lei Wang, Ting Zhang, Juan Du, Lidan Yang, Wenquan Yi

Published in

Frontiers in oncology. Volume 16. Pages 1887590. Epub Aug 14, 2026.

Abstract

To conduct a systematic review and meta-analysis comparing the therapeutic efficacy of endoscopic full-thickness resection (EFTR) and endoscopic submucosal dissection (ESD) for colorectal lesions.
A comprehensive search of PubMed, Web of science, Cochrane Library and Embase databases until October 1, 2025, supplemented by manual reference screening, identified studies comparing EFTR and ESD. Studies were selected based on predefined inclusion/exclusion criteria, with methodological quality assessed using standardized tools. Meta-analysis was performed using RevMan 5.4, calculating pooled odds ratios (OR) and standardized mean differences (SMD) with 95% confidence intervals.
Five studies involving 570 patients were analyzed. EFTR and ESD showed comparable en bloc resection rates (OR = 2.59, 95%CI 0.38 ∼ 17.77, P = 0.33) and R0 resection rates (OR = 1.73, 95%CI 0.71 ∼ 4.20, P = 0.23). EFTR demonstrated superior safety profiles with significantly lower postoperative perforation risk (OR = 0.13, 95%CI 0.05 ∼ 0.37, P < 0.001), reduced post-polypectomy syndrome incidence (OR = 0.23, 95%CI 0.08 ∼ 0.68, P = 0.008), and shorter procedure time (SMD=-1.97, 95%CI -2.95 ∼ -0.99, P < 0.001). No significant differences were observed in postoperative bleeding (OR = 0.96, 95%CI 0.31 ∼ 2.94, P = 0.94) or lesion recurrence rates (OR = 2.47, 95%CI 0.76 ∼ 8.01, P = 0.13).
In summary, EFTR yields favorable short-term outcomes for selected small or refractory colorectal lesions, particularly non-lifting or recurrent lesions, whereas ESD remains essential for larger superficial colorectal neoplasia requiring en bloc resection.
https://www.crd.york.ac.uk/PROSPERO, identifier CRD42024534672.

PMID:
42666205
Bibliographic data and abstract were imported from PubMed on 29 Aug 2026.

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