Comparative Clinical Outcomes of Various Colorectal Endoscopic Submucosal Dissection Techniques: A Systematic Review and Network Meta-Analysis

Background/Aims: Traction-assisted endoscopic submucosal dissection (T-ESD), hybrid ESD (H-ESD), pocket-creation method ESD (P-ESD), and underwater ESD (U-ESD) were introduced to overcome the limitations of conventional ESD (C-ESD). We conducted a systematic review and network meta-analysis to compare the clinical outcomes of different colorectal ESD techniques. Methods: resection, complete resection, perforation, and delayed bleeding were compared using network meta-analysis. Results: resection (6.5), complete resection (23.3), and delayed bleeding (23.6) according to SUCRA values. Regarding safety outcomes, T-ESD showed the most favorable SUCRA ranking for perforation (73.6), and U-ESD showed the most favorable SUCRA ranking for delayed bleeding (74.9). Conclusions: resection, complete resection, and delayed bleeding.