S417 Meta-Analysis Comparing Double Balloon vs Standard Endoscopic Submucosal Dissection for Colorectal Lesions

Introduction: Clinical studies have shown conflicting results comparing double balloon endoscopic submucosal dissection (ESD) to standard ESD for colorectal lesions. We performed a meta-analysis to reconcile the data. Methods: Multiple online databases were searched for studies evaluating double balloon vs standard ESD for colorectal lesions. The outcomes of interest were length (cm)/area of the specimen (cm²), en bloc resection, R0 resection, procedure time (min), dissection time (min), dissection speed (cm²/hour), adverse events and residual/recurrent lesions. Odds ratios (OR) and standardized mean difference (SMD), with 95% confidence intervals (CI) were calculated. Results: A total of 6 studies with 754 patients (n = 354 double balloon ESD, n = 400 standard ESD) were included. The mean age was 67 years and 56% of patients were male. As compared with the standard ESD group, double balloon ESD was associated with significant reduction in dissection time (SMD -0.49, 95% CI -0.75 to -0.24, P = 0.0002), with no significant differences in total procedure time (SMD -0.35, 95% CI -0.74 to 0.05, P = 0.08), specimen area (SMD 0.02, 95% CI -0.20 to 0.24), en bloc resection (OR 1.63, 95% CI 0.73 to 3.63), R0 resection (OR 1.06, 95% CI 0.20 to 5.64) and adverse events. Conclusion: Double balloon ESD may help in reducing time for dissection of colorectal lesions when compared to standard ESD.