Endoscopic submucosal dissection vs transanal endoscopic surgery for rectal tumors: A systematic review and meta-analysis

Table 1 Characteristics of included studies

Ref.	Country	Study design	Sample size in ESD group	Sample size in TES group	Study participants details	Surgeons for ESD	Surgeons for TES	Mean age (yr)	Risk of bias
Bisogni et al[22], 2020	Italy	Retrospective	13	36	Patients with superficial rectal lesions such as adenomas with negative lifting sign, T1 carcinoma with indication for endoscopic resection and subepithelial colorectal tumour	Three over ten years’ experience endoscopists	Three experienced surgeons performed all the TES procedures	ESD = 74.92; TES = 69.17	High
Jin et al[23], 2023	China	Retrospective	14	49	Patients with rectal neuroendocrine tumours ≤ 2 cm	Experienced endoscopist team, who had completed over 5000 cases for colonoscopy training and completed more than 300 cases for ESD	Experienced surgeon who had completed over 300 cases for TES training	ESD = 52.9; TES = 51.1	Moderate
Jung et al[19], 2018	Korea	Retrospective	40	16	Patients with epithelial rectal tumour	One experienced endoscopist	One experienced surgeon	ESD = 67.4; TES = 68.4	Moderate
Kawaguti et al[21], 2014	Brazil	Retrospective	11	13	Patients with early-stage rectal cancer	NR	NR	ESD = 62.3; TES =61.5	High
Kim et al[24], 2023	United States	Retrospective	101	103	Patients with early-stage rectal cancer	NR	NR	ESD = 63; TES = 62	Moderate
Kimura et al[25], 2021	Brazil	Retrospective	71	27	Consecutive patients undergoing either ESD or TES	Endoscopist who performed all the ESD procedures had previous training in this technique and had performed more than 20 cases/yr	Two colorectal surgeons performed TEM and both had previous training in this method, had performed more than 20 cases per year	ESD = 65.5; TES = 64.9	Moderate
Mao et al[18], 2017	China	Retrospective	31	26	Patients with early-stage rectal tumour	Senior colorectal surgeons and assistants with expertise in endoscopic operations	Experienced colorectal surgeons	ESD = 52.1; TES =54.8	High
Mittal et al[16], 2018	India	Retrospective	31	19	Patients with rectal polyps	NR	NR	NR	High
Park et al[20], 2012	Korea	Retrospective	30	33	Patients with nonpolypoid high-grade dysplasia or cancer invading the submucosa	One experienced endoscopist	Experienced surgeons	ESD = 58.6; TES = 59.5	Low
Park et al[26], 2021	Korea	Retrospective	226	59	Patients with rectal neuroendocrine tumours	Four experienced endoscopist	One surgeon	ESD = 48.92; TES = 50.85	Low
Tajika et al[17], 2016	India	Retrospective	48	28	Patients with lower rectal tumour	NR	NR	NR	High

ESD: Endoscopic submucosal dissection; NR: Not reported; TES: Transanal endoscopic surgery.