Use of Confocal Laser Endomicroscopy to Assess the Adequacy of Endoscopic Treatment of Gastrointestinal Neoplasia: A Systematic Review and Meta-AnalysisYpsilantis, Efthymios MSc, MPhil, MRCS; Pissas, Dimitrios MD, PhD; Papagrigoriadis, Savvas MD, MSc, FRCS; Haji, Amyn MA, MBBChir, MSc, MD, FRCSSurgical Laparoscopy, Endoscopy & Percutaneous Techniques: February 2015 - Volume 25 - Issue 1 - p 1–5 doi: 10.1097/SLE.0000000000000072 Review Articles Buy Abstract Author InformationAuthors Article MetricsMetrics Evaluation of the adequacy of endoscopic mucosal resection (EMR) of gastrointestinal lesions remains challenging by use of conventional endoscopy. Confocal laser endomicroscopy (CLE) is a novel imaging technique, designed to provide in vivo histology, and facilitate diagnosis with real-time intervention. We undertook a systematic review of the available literature, exploring the role of CLE in assuring completeness of EMR of gastrointestinal lesions. The number of pertinent studies is very limited, including only 1 randomized controlled study and 2 prospective comparative case series. Per-lesion meta-analysis showed that the sensitivity of CLE for detection of residual neoplasia was 91% (95% confidence interval, 82.5%-96%) with specificity of 69% (95% confidence interval, 61%-77%), with significant heterogeneity noted in all outcomes. In conclusion, the evidence underpinning the usefulness of CLE in ensuring adequate EMR of gastrointestinal neoplasia is currently very weak, with limited promising results related to gastric and colorectal polyp resections. Department of Colorectal Surgery and Endoscopy, King’s College Hospital, Denmark Hill, London, UK The authors declare no conflicts of interest. Reprints: Efthymios Ypsilantis, MSc, MPhil, MRCS, Department of Colorectal Surgery and Endoscopy, King’s College Hospital, Denmark Hill, London SE5 9RS, UK (e-mail: firstname.lastname@example.org). Received March 31, 2014 Accepted April 15, 2014 Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.