Sahib Singh, MD1, Babu P. Mohan, MD2, Parth Patel, MD3, Dushyant S. Dahiya, MD4, Vishnu Charan Suresh Kumar, MD5, Sumant Inamdar, MD6, Ganesh Aswath, MD7, Douglas G. Adler, MD, FACG8 1Sinai Hospital, Baltimore, MD; 2Orlando Gastroenterology PA, Orlando, FL; 3Ascension Saint Joseph Hospital, Chicago, IL; 4University of Kansas School of Medicine, Kansas City, KS; 5Staten Island University Hospital, Northwell Health, Staten Island, NY; 6University of Arkansas for Medical Sciences, Little Rock, AR; 7SUNY Upstate Medical University Hospital, Syracuse, NY; 8Center for Advanced Therapeutic (CATE), Centura Health, Porter Adventist Hospital, Peak Gastroenterology, Denver, CO 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. Discussion: Double balloon ESD may help in reducing time for dissection of colorectal lesions when compared to standard ESD.
Figure: Dissection time
Figure: En bloc resection
Disclosures: Sahib Singh indicated no relevant financial relationships. Babu Mohan indicated no relevant financial relationships. Parth Patel indicated no relevant financial relationships. Dushyant Dahiya indicated no relevant financial relationships. Vishnu Charan Suresh Kumar indicated no relevant financial relationships. Sumant Inamdar indicated no relevant financial relationships. Ganesh Aswath indicated no relevant financial relationships. Douglas Adler: Boston Scientific – Consultant.
Sahib Singh, MD1, Babu P. Mohan, MD2, Parth Patel, MD3, Dushyant S. Dahiya, MD4, Vishnu Charan Suresh Kumar, MD5, Sumant Inamdar, MD6, Ganesh Aswath, MD7, Douglas G. Adler, MD, FACG8. P2440 - Meta-Analysis Comparing Double Balloon vs Standard Endoscopic Submucosal Dissection for Colorectal Lesions, ACG 2025 Annual Scientific Meeting Abstracts. Phoenix, AZ: American College of Gastroenterology.
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