Introduction: Compared with conventional endoscopic submucosal dissection (C-ESD) for colorectal lesions, the traction method (T-ESD) allows the lesion to be stabilized with easier dissection. However, randomized controlled trials (RCTs) have reported conflicting results on the clinical outcomes of T-ESD as compared with C-ESD. We conducted a meta-analysis to compile the data.
Methods: Multiple databases were searched for RCTs evaluating C-ESD versus T-ESD for colorectal tumors. The end points of interest were procedure time (min), resection speed (mm²/min), R0 resection, en bloc resection, delayed bleeding, and perforation. Standard meta-analysis methods were employed using the random-effects model.
Results: Six RCTs with a total of 566 patients (C-ESD n=284, T-ESD n=282) were included. The mean age was 67±10 y and 60% were men. As compared with the T-ESD technique, the C-ESD group was associated with longer procedure time (SMD 0.91, 95% CI 0.58 to 1.23, P<0.00001) and lesser resection speed (SMD -1.03, 95% CI -2.01 to -0.06, P=0.04). No significant difference was found in the 2 groups with respect to R0 resection rate (RR 1.00, 95% CI 0.94 to 1.06, P=0.87), en bloc resection (RR 0.99, 95% CI 0.97 to 1.01, P=0.35), delayed bleeding (RR 0.66, 95% CI 0.17 to 2.59, P=0.55) and perforation (RR 2.16, 95% CI 0.75 to 6.27, P=0.16).
Discussion: On meta-analysis, pooled procedure time was significantly faster with T-ESD compared with C-ESD. The clinical outcomes, however, were comparable.
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http://dx.doi.org/10.1097/MCG.0000000000001973 | DOI Listing |
BMC Womens Health
December 2024
Department of Obstetrics and Gynecology, School of Medicine, Debre Markos University, Debre Markos, Amhara Region, Ethiopia.
Background: Hysteroscopy is considered the standard for evaluating the uterine cavity. Limited data exists regarding hysteroscopy in Ethiopia. Therefore, the objective of the study was to describe the diagnostic and operative hysteroscopic procedures at St.
View Article and Find Full Text PDFUnited European Gastroenterol J
December 2024
Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.
Introduction: Long-term data on metachronous advanced adenoma (AA) recurrence after endoscopic submucosal dissection (ESD) remain scarce, leading to a lack of a standardized surveillance strategy. This study aims to evaluate the long-term risk of recurrent AA after ESD.
Materials And Methods: A longitudinal retrospective cohort study with propensity-score matching was conducted in a tertiary hospital in Hong Kong.
Tech Coloproctol
December 2024
Department of Colorectal Surgery, Digestive Disease and Surgery Institute, Cleveland Clinic, 9500 Euclid Avenue A-30, Cleveland, OH, 44195, USA.
Effective closure of both muscular and mucosal defects after endoscopic submucosal dissection (ESD) remains a technical challenge. Failure to adequately address such defects may increase the risk of delayed perforation. In this video case report, we demonstrate the application of the through-the-scope (TTS) tack system for defect closure following ESD in a patient with a cecal lesion.
View Article and Find Full Text PDFGastrointest Endosc
January 2025
Department of Gastroenterology and Endoscopy, Dupuytren University Hospital, Limoges, France.
Objectives: Colorectal endoscopic submucosal dissection (ESD) for large tumors is spreading worldwide. Gastric cancer (GC) sometimes occurs after colorectal ESD. However, its status including frequency and risk factors have not been examined well.
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