Yu-Zhi Liu1, Xiu-He Lv1, Kai Deng1, Jin-Lin Yang1. 1. Department of Gastroenterology and Hepatology, West China Hospital of Sichuan University, Chengdu, China.
Abstract
OBJECTIVE: Endoscopic submucosal tunnel dissection (ESTD), which is a new treatment for upper gastrointestinal superficial precancerous lesions and tumors has been proposed in recent years. However, compared with endoscopic submucosal dissection (ESD), the safety and efficacy of ESTD for treating these lesions are still uncertain. The aim of this meta-analysis was to compare the efficacy and safety of these two endoscopic procedures for the treatment of superficial upper gastrointestinal superficial precancerous lesions and tumors. METHODS: Electronic databases, including Embase, PubMed, Cochrane Library and Web of Science, were systematically searched. Related literature was retrieved until April 1, 2020. The primary outcomes were complete resection rate and en bloc resection rate. The secondary outcomes were operation time, dissection speed, complication rates and recurrence rates. The Newcastle-Ottawa Quality Assessment Scale (NOS) was adopted to evaluate the quality of the studies. RESULTS: Seven researches were included in the final meta-analysis. The complete resection rate and en bloc resection rates between ESTD group and ESD group were similar for early superficial esophageal lesions. Compared with the ESD group, the ESTD group had a higher complete resection rate and en bloc resection rate for early superficial gastric lesions and a faster dissection speed in both superficial esophageal lesions and gastric lesions. For superficial gastric lesions, the operation time of the ESTD group was shorter than that of the ESD group, while the operation times were similar between the groups for superficial esophageal lesions. There were no obvious differences in the bleeding rate and perforation rate between the ESTD group and the ESD group. CONCLUSION: As an endoscopic resection technique for early upper gastrointestinal superficial lesions, ESTD is equally as safe and more effective than ESD, especially for gastric lesion. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
OBJECTIVE: Endoscopic submucosal tunnel dissection (ESTD), which is a new treatment for upper gastrointestinal superficial precancerous lesions and tumors has been proposed in recent years. However, compared with endoscopic submucosal dissection (ESD), the safety and efficacy of ESTD for treating these lesions are still uncertain. The aim of this meta-analysis was to compare the efficacy and safety of these two endoscopic procedures for the treatment of superficial upper gastrointestinal superficial precancerous lesions and tumors. METHODS: Electronic databases, including Embase, PubMed, Cochrane Library and Web of Science, were systematically searched. Related literature was retrieved until April 1, 2020. The primary outcomes were complete resection rate and en bloc resection rate. The secondary outcomes were operation time, dissection speed, complication rates and recurrence rates. The Newcastle-Ottawa Quality Assessment Scale (NOS) was adopted to evaluate the quality of the studies. RESULTS: Seven researches were included in the final meta-analysis. The complete resection rate and en bloc resection rates between ESTD group and ESD group were similar for early superficial esophageal lesions. Compared with the ESD group, the ESTD group had a higher complete resection rate and en bloc resection rate for early superficial gastric lesions and a faster dissection speed in both superficial esophageal lesions and gastric lesions. For superficial gastric lesions, the operation time of the ESTD group was shorter than that of the ESD group, while the operation times were similar between the groups for superficial esophageal lesions. There were no obvious differences in the bleeding rate and perforation rate between the ESTD group and the ESD group. CONCLUSION: As an endoscopic resection technique for early upper gastrointestinal superficial lesions, ESTD is equally as safe and more effective than ESD, especially for gastric lesion. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.