Effectiveness and safety of endoscopic submucosal dissection using the pocket creation method in the Japanese population: a systematic review and meta-analysis
Background and study aims Endoscopic submucosal dissection (ESD) is a standard method for minimally invasive resection of superficial gastrointestinal tumors. The pocket creation method (PCM) facilitates ESD regardless of location in the gastrointestinal tract. The aim of this systematic review and...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Georg Thieme Verlag KG
2022-05-01
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| Series: | Endoscopy International Open |
| Online Access: | http://www.thieme-connect.de/DOI/DOI?10.1055/a-1789-0548 |
| _version_ | 1811233107045515264 |
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| author | Satoshi Shinozaki Yoshikazu Hayashi Yoshimasa Miura Tomonori Yano Alan Kawarai Lefor Hironori Yamamoto |
| author_facet | Satoshi Shinozaki Yoshikazu Hayashi Yoshimasa Miura Tomonori Yano Alan Kawarai Lefor Hironori Yamamoto |
| author_sort | Satoshi Shinozaki |
| collection | DOAJ |
| description | Background and study aims Endoscopic submucosal dissection (ESD) is a standard method for minimally invasive resection of superficial gastrointestinal tumors. The pocket creation method (PCM) facilitates ESD regardless of location in the gastrointestinal tract. The aim of this systematic review and meta-analysis is to evaluate the effectiveness and safety of ESD for superficial neoplasms in the upper and lower gastrointestinal tract comparing the PCM to the non-PCM.
Methods Randomized controlled, prospective, and retrospective studies comparing the PCM with the non-PCM were included. Outcomes included en bloc resection, R0 resection, dissection speed, delayed bleeding and perforation. Pooled odds ratios (ORs) with 95 % confidence intervals (CIs) using the Mantel-Haenszel random effect model were documented.
Results Eight studies including gastric, duodenal, and colorectal ESD were included. The en bloc resection rate was significantly higher in the PCM group than the non-PCM group (OR 3.87, 95 %CI 1.24–12.10 P = 0.020). The R0 resection rate was significantly higher in the PCM group than the non-PCM group (OR 2.46, 95 %CI 1.14–5.30, P = 0.020). The dissection speed was significantly faster in the PCM group than the non-PCM group (mean difference 3.13, 95 % CI 1.35–4.91, P < 0.001). The rate of delayed bleeding was similar in the two groups (OR 1.13, 95 %CI 0.60–2.15, P = 0.700). The rate of perforation was significantly lower in the PCM group than the non-PCM group (OR 0.34, 95 %CI 0.15–0.76, P = 0.009).
Conclusions The PCM facilitates high-quality, fast and safe colorectal ESD. Further studies are needed regarding the utility of PCM in ESD of the upper gastrointestinal tract. |
| first_indexed | 2024-04-12T11:14:50Z |
| format | Article |
| id | doaj.art-901c055b8b7640cd96c78e1ac763f8b4 |
| institution | Directory Open Access Journal |
| issn | 2364-3722 2196-9736 |
| language | English |
| last_indexed | 2024-04-12T11:14:50Z |
| publishDate | 2022-05-01 |
| publisher | Georg Thieme Verlag KG |
| record_format | Article |
| series | Endoscopy International Open |
| spelling | doaj.art-901c055b8b7640cd96c78e1ac763f8b42022-12-22T03:35:31ZengGeorg Thieme Verlag KGEndoscopy International Open2364-37222196-97362022-05-011005E694E70210.1055/a-1789-0548Effectiveness and safety of endoscopic submucosal dissection using the pocket creation method in the Japanese population: a systematic review and meta-analysisSatoshi Shinozaki0Yoshikazu Hayashi1Yoshimasa Miura2Tomonori Yano3Alan Kawarai Lefor4Hironori Yamamoto5Shinozaki Medical Clinic, Utsunomiya, JapanDepartment of Medicine, Division of Gastroenterology, Jichi Medical University, Shimotsuke, JapanDepartment of Medicine, Division of Gastroenterology, Jichi Medical University, Shimotsuke, JapanDepartment of Medicine, Division of Gastroenterology, Jichi Medical University, Shimotsuke, JapanDepartment of Surgery, Jichi Medical University, Shimotsuke, JapanDepartment of Medicine, Division of Gastroenterology, Jichi Medical University, Shimotsuke, JapanBackground and study aims Endoscopic submucosal dissection (ESD) is a standard method for minimally invasive resection of superficial gastrointestinal tumors. The pocket creation method (PCM) facilitates ESD regardless of location in the gastrointestinal tract. The aim of this systematic review and meta-analysis is to evaluate the effectiveness and safety of ESD for superficial neoplasms in the upper and lower gastrointestinal tract comparing the PCM to the non-PCM. Methods Randomized controlled, prospective, and retrospective studies comparing the PCM with the non-PCM were included. Outcomes included en bloc resection, R0 resection, dissection speed, delayed bleeding and perforation. Pooled odds ratios (ORs) with 95 % confidence intervals (CIs) using the Mantel-Haenszel random effect model were documented. Results Eight studies including gastric, duodenal, and colorectal ESD were included. The en bloc resection rate was significantly higher in the PCM group than the non-PCM group (OR 3.87, 95 %CI 1.24–12.10 P = 0.020). The R0 resection rate was significantly higher in the PCM group than the non-PCM group (OR 2.46, 95 %CI 1.14–5.30, P = 0.020). The dissection speed was significantly faster in the PCM group than the non-PCM group (mean difference 3.13, 95 % CI 1.35–4.91, P < 0.001). The rate of delayed bleeding was similar in the two groups (OR 1.13, 95 %CI 0.60–2.15, P = 0.700). The rate of perforation was significantly lower in the PCM group than the non-PCM group (OR 0.34, 95 %CI 0.15–0.76, P = 0.009). Conclusions The PCM facilitates high-quality, fast and safe colorectal ESD. Further studies are needed regarding the utility of PCM in ESD of the upper gastrointestinal tract.http://www.thieme-connect.de/DOI/DOI?10.1055/a-1789-0548 |
| spellingShingle | Satoshi Shinozaki Yoshikazu Hayashi Yoshimasa Miura Tomonori Yano Alan Kawarai Lefor Hironori Yamamoto Effectiveness and safety of endoscopic submucosal dissection using the pocket creation method in the Japanese population: a systematic review and meta-analysis Endoscopy International Open |
| title | Effectiveness and safety of endoscopic submucosal dissection using the pocket creation method in the Japanese population: a systematic review and meta-analysis |
| title_full | Effectiveness and safety of endoscopic submucosal dissection using the pocket creation method in the Japanese population: a systematic review and meta-analysis |
| title_fullStr | Effectiveness and safety of endoscopic submucosal dissection using the pocket creation method in the Japanese population: a systematic review and meta-analysis |
| title_full_unstemmed | Effectiveness and safety of endoscopic submucosal dissection using the pocket creation method in the Japanese population: a systematic review and meta-analysis |
| title_short | Effectiveness and safety of endoscopic submucosal dissection using the pocket creation method in the Japanese population: a systematic review and meta-analysis |
| title_sort | effectiveness and safety of endoscopic submucosal dissection using the pocket creation method in the japanese population a systematic review and meta analysis |
| url | http://www.thieme-connect.de/DOI/DOI?10.1055/a-1789-0548 |
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