[Endoscopic mucosal resection (EMR) and endoscopic mucosal dissection (EMD) in superficial gastrointestinal tumors]

Benguria-Arrate G, Gutiérrez-Ibarluzea I, Galnares L
Record ID 32018000491
Original Title: Resección mucosa endoscópica (RME) y disección submucosa endoscópica (DSE) en cánceres gastrointestinales superficiales
Authors' objectives: To assess the implementation of the techniques of Endoscopic Mucosal Resection (EMR) and Endoscopic Mucosal Dissection (EMD).
Authors' results and conclusions: One complete report of the ECRI Institute was selected, which was drawn up using two systematic reviews (annexes), seven comparative studies (annexes), 22 case series, eight retrospective observational studies, 13 narrative reviews and three relevant clinical practice guides. These studies published results on the evidence of these techniques in different localisations of gastrointestinal cancer. No studies on the costs of the technologies were located. EMD (and EMR) are purely therapeutic techniques, the main objective of which is the curative resection of digestive lesions. f implementation of the procedure is proposed, the focus should be on the number of patients and learning curves that are required. The procedure can be seen as an opportunity to maintain the skills and knowledge of professionals in the innovative areas network. CONCLUSIONS EMD gives better rates of complete resection (R0) and local relapse is minimal in comparison with EMR, but EMD is a technique that requires more learning time for the same complication rate. At the same time the different approaches and results of the technique with regard to the particular location of the lesion to be treated should be taken into consideration. Both technologies (EMR and EMD) require adequate training periods (greater in the case of EMD to achieve a complication rate similar to RME) and established learning curves. An evidence generation process amongst selected patients, including a comparison with standard treatments, is regarded as appropriate.
Authors' methods: Search without time limit of the scientific literature in data bases that bring together primary, secondary and applied research studies such as the DB of Medline, CRD (INAHTA, NHS EED, DARE), Cochrane Collaboration, National Guidelines Clearing House (NGC), EuroScan and ECRI in order to locate systematic reviews, Clinical Practice Guides or clinical tests that analyse the technique to be studied.
Project Status: Completed
Year Published: 2017
English language abstract: An English language summary is available
Publication Type: Rapid Review
Country: Spain
MeSH Terms
  • Gastrointestinal Neoplasms
  • Dissection
  • Endoscopy, Gastrointestinal
  • Learning Curve
  • Barrett Esophagus
  • Colorectal Neoplasms
  • Stomach Neoplasms
  • Minimally Invasive Surgical Procedures
  • Gastrointestinal Neoplasms
  • Endoscopic Mucosal Resection
  • Endoscopic Submucosal Dissection
  • Neoplasias Gastrointestinales
  • Resección Endoscópica de la Mucosa
  • Disección de la Submucosa Endoscópica
Organisation Name: Basque Office for Health Technology Assessment
Contact Address: C/ Donostia – San Sebastián, 1 (Edificio Lakua II, 4ª planta) 01010 Vitoria - Gasteiz
Contact Name: Lorea Galnares-Cordero
Contact Email: lgalnares@bioef.eus
Copyright: Osteba (Basque Office for Health Technology Assessment) Health Department of the Basque Government
This is a bibliographic record of a published health technology assessment from a member of INAHTA or other HTA producer. No evaluation of the quality of this assessment has been made for the HTA database.