S407 Comparative Efficacy of Precut Endoscopic Mucosal Resection and Endoscopic Submucosal Dissection for Colorectal Polyps: A Systematic Review and Meta-Analysis

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Introduction: Colonoscopy is a vital procedure for colorectal cancer screening and intervention, yet it can be uncomfortable for patients, particularly the elderly and those with diverticular disease. In our systematic review and meta-analysis, we aimed to evaluate the impact of abdominal compression devices (ACDs) on patient comfort and procedural efficiency during colonoscopy. Methods: Systematic literature retrieval was performed in PubMed, Web of Science, Scopus, Chochrane central and Embase from inception to April 2025. Risk of bias assessment was performed by using Cochrane tool for assessing risk of bias in randomized trials (ROB2). Data-analysis was conducted using R version 4.2.2 (2022-10-31) and RStudio version 2022.07.2 (2009-2022, RStudio, Inc.). Results: Our comprehensive search across multiple databases yielded 16 randomized controlled trials (RCTs) involving 3,098 participants. Our analysis revealed that ACDs significantly reduced cecal intubation time (CIT) (MD: -2.20, 95% confidence interval [CI]: -3.50 – -0.90; P = 0.0009), manual pressure application (risk ratio [RR]: 0.54, 95% CI: 0.39–0.76; P = 0.0003), and the need for patient repositioning (RR: 0.55, 95% CI: 0.48–0.64; P > 0.0001). Additionally, ACDs were associated with lower visual analog scale pain scores, indicating enhanced patient satisfaction. However, there were no significant differences in complete colonoscopy rates or cecal intubation lengths. Conclusion: Our findings suggest that ACDs can optimize colonoscopy procedures, improve patient comfort, and reduce staff workload, warranting their integration into routine practice. Future studies should focus on standardizing ACD applications and exploring long-term outcomes to further enhance the benefits of this approach in clinical settings.

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