{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,19]],"date-time":"2026-04-19T17:24:11Z","timestamp":1776619451720,"version":"3.51.2"},"reference-count":23,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2019,5,23]],"date-time":"2019-05-23T00:00:00Z","timestamp":1558569600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Colorectal Disease"],"published-print":{"date-parts":[[2019,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>In patients who have undergone a polypectomy of a malignant rectal polyp without histopathological risk factors other than an involved or unclear resection margin, additional local excision is often performed. Evidence to support this approach is lacking. The aim of this systematic review and meta\u2010analysis was to determine the outcome in terms of local recurrence, disease\u2010free survival (DFS) and overall survival (OS) of additional local excision following incomplete polypectomy for low risk T1 rectal cancer.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A comprehensive search for published studies was performed. Only studies in which there was incomplete (or \u2264\u00a01\u00a0mm) removal of <jats:styled-content style=\"fixed-case\">pT<\/jats:styled-content>1 rectal polyps or in which the resection plane could not be assessed were included. For each included study data on tumour stage, histological factors, surgical technique, local recurrence rate, 5\u2010year <jats:styled-content style=\"fixed-case\">DFS<\/jats:styled-content> and 5\u2010year <jats:styled-content style=\"fixed-case\">OS<\/jats:styled-content> were extracted. The <jats:styled-content style=\"fixed-case\">PROSPERO<\/jats:styled-content> registration number is <jats:styled-content style=\"fixed-case\">CRD<\/jats:styled-content>42017062702.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 580 studies were retrieved by the search in the MEDLINE database, Embase and the Cochrane Library. After careful appreciation, four studies were included in the analysis, comprising 102 patients of whom the majority had undeterminable (Rx) resection margins. Local excision via transanal endoscopic microsurgery was reported most frequently. Only 1% of patients developed a local recurrence. One study reported 5\u2010year <jats:styled-content style=\"fixed-case\">DFS<\/jats:styled-content> and 5\u2010year <jats:styled-content style=\"fixed-case\">OS<\/jats:styled-content> of 96% and 87% respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This study supports the use of additional local excision techniques for rectal cancer patients who underwent an incomplete polypectomy for a malignant rectal polyp in the absence of risk factors other than an uncertain resection margin.<\/jats:p><\/jats:sec>","DOI":"10.1111\/codi.14659","type":"journal-article","created":{"date-parts":[[2019,5,10]],"date-time":"2019-05-10T09:35:49Z","timestamp":1557480949000},"page":"1112-1119","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Minimally invasive transanal surgery is safe after incomplete polypectomy of low risk T1 rectal cancer: a systematic review"],"prefix":"10.1111","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2755-5260","authenticated-orcid":false,"given":"G. 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