Efficacy and safety of endoscopic submucosal tunnel dissection for superficial esophageal squamous cell carcinoma: a propensity score matching analysis

Huang, Rui; Cai, Hong; Zhao, Xin; Lu, Xiaoqiang; Liu, Min; Lv, Wenhao; Liu, Zhiguo; Wu, Kaichun; Han, Ying

doi:10.1016/j.gie.2017.03.001

Cited by 40 publications

(23 citation statements)

References 23 publications

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“…A total of 22 studies were further excluded for the following reasons: (a) insufficient data; (b) duplicates; (c) irrelevant to the review topic; (d) studies on animal models; and (e) case reports and review articles. Seven studies 7‐13 were finally inclued for this meta‐analysis.…”

Section: Resultsmentioning

confidence: 99%

Efficacy and safety of endoscopic submucosal tunnel dissection vs endoscopic submucosal dissection for early superficial upper gastrointestinal precancerous lesions and tumors: A meta‐analysis

Liu

Deng

et al. 2020

J of Digest Diseases

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Objective Endoscopic submucosal tunnel dissection (ESTD) is a new treatment for superficial upper gastrointestinal precancerous lesions and tumors. However, its safety and efficacy for treating these lesions is still uncertain. This meta‐analysis aimed to compare the efficacy and safety of ESTD with those of endoscopic submucosal dissection (ESD) in treating early superficial upper gastrointestinal precancerous lesions and tumors. Methods Electronic databases, including EMBASE, PubMed, Cochrane Library and the Web of Science, were systematically searched for articles published up to 1 April 2020. The primary outcomes were complete and en bloc resection rates of the lesions. The secondary outcomes included operation time, speed of dissection, complication and recurrence rates. The Newcastle‐Ottawa quality assessment scale was used to evaluate the quality of the studies. Results Seven studies were included in the final meta‐analysis. The complete and en bloc resection rates of early superficial esophageal lesions as well as the en bloc resection rate of early superficial gastric lesions were similar between the ESTD and ESD groups. Compared with the ESD group, the ESTD group had a higher en bloc resection rate for early superficial gastric lesions. A faster dissection speed was observed in both superficial esophageal and gastric lesions. In gastric lesions, the operation time of the ESTD group was shorter than that of the ESD group, while it did not differ for esophageal lesions. There were no obvious differences in bleeding and perforation rates between the groups. Conclusion As an endoscopic technique for treating early superficial upper gastrointestinal lesions, ESTD is as safe as and more effective than ESD, especially for gastric lesions.

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Section: Resultsmentioning

confidence: 99%

Efficacy and safety of endoscopic submucosal tunnel dissection vs endoscopic submucosal dissection for early superficial upper gastrointestinal precancerous lesions and tumors: A meta‐analysis

Liu

Deng

et al. 2020

J of Digest Diseases

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“…1). Of these included studies, three were prospective and six were retrospective [12,[17][18][19][20][21][22][23][24].…”

Section: Search Resultsmentioning

confidence: 99%

Efficacy and safety of endoscopic submucosal tunnel dissection for superficial esophageal neoplastic lesions: a systematic review and meta-analysis

Peng

Tan

Ren

et al. 2020

J Cardiothorac Surg

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Background: Presently, endoscopic submucosal tunnel dissection (ESTD) has been a novel therapy for superficial esophageal neoplastic lesions (SENL), especially for circumferential neoplastic lesions. A number of studies have reported the clinical application of ESTD with promising outcomes. Therefore, we conducted a systematic review and meta-analysis to evaluated the efficacy and safety of ESTD for SENL. Methods: From 2013 to November 2018, Pubmed, Embase and Cochrane databases were searched to determine studies reporting ESTD treatment of SENL. Weighted pooled rates (WPR) were calculated for en bloc resection, R0 resection and complication of ESTD. Risk ratios (RR) were calculated and pooled to compare the clinical outcomes of ESTD with ESD for SENL. Results: A total of 9 studies involving 494 patients with 518 esophageal neoplastic lesions were included in our study. WPR for en bloc resection and R0 resection of ESTD was 97.0% (95% CI: 94.7-98.3%) and 84.1% (95% CI: 80.5-87.1%), respectively. WPR for complication was 40.0% (95% CI: 25.8-56.1%). Two studies with 265 patients compared the performance of ESTD with ESD. Pooled RR for en bloc resection and R0 resection was 1.04 (95% CI: 0.95-1.14, P = 0.42) and 1.01 (95% CI: 0.93-1.10, P = 0.73), respectively. Pooled RR for complication was 0.68 (95% CI: 0.46-1.01, P = 0.05). Conclusion: Our study showed that ESTD is effective for treating SENL with high en bloc resection rate and R0 resection rate, but accompanying by a relatively high complications.

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“…Three studies investigated the efficacy of clip line traction, and the remaining two articles evaluated endoscopic submucosal tunneling dissection (ESTD) compared with conventional ESD (Table 1). [14][15][16][17][18] Clip line traction is a simple and an inexpensive technique to obtain traction during ESD. 19 An endoclip is inserted through the accessory channel of a gastroscope, and a thread, typically dental floss, is tied to the tip of the endoclip outside the patient.…”

Section: Esophagusmentioning

confidence: 99%

“…ESTD is indicted for lesions >20 mm in diameter and involving at least one third of the esophageal circumference. 20 A propensity matching analysis by Huang et al 18 demonstrated ESTD significantly shortened the ESD procedural time (38.0 minutes vs 48.0 minutes, p=0.006) and the submucosal dissection time (30.0 minutes vs 40.0 minutes, p=0.005) compared with conventional ESD. In addition, ESTD reduced the rate of muscular injury, although there was no statistical difference in the adverse events.…”

Section: Esophagusmentioning

confidence: 99%

Efficacy of Current Traction Techniques for Endoscopic Submucosal Dissection

Abe

Ego

et al. 2020

Gut and Liver

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This systematic review aimed to assess the efficacy of the current approach to tissue traction during the endoscopic submucosal dissection (ESD) of superficial esophageal cancer, early gastric cancer, and colorectal neoplasms. We performed a systematic electronic literature search of articles published in PubMed and selected comparative studies to investigate the treatment outcomes of tractionassisted versus conventional ESD. Using the keywords, we retrieved 381 articles, including five eligible articles on the esophagus, 13 on the stomach, and 12 on the colorectum. A total of seven randomized controlled trials and 23 retrospective studies were identified. Clip line traction and submucosal tunneling were effective in reducing the procedural time during esophageal ESD. The efficacy of traction methods in gastric ESD varied in terms of the devices and strategies used depending on the lesion location and degree of submucosal fibrosis. Several prospective and retrospective studies utilized traction devices without the need to reinsert the colonoscope. When pocket creation is included, the traction devices and methods effectively shorten the procedural time during colorectal ESD. Conclusions: Although the efficacy is dependent on the organ and tumor locations, several traction techniques have been demonstrated to be efficacious in facilitating ESD by maintaining satisfactory traction during dissection. (Gut Liver,

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Efficacy and safety of endoscopic submucosal tunnel dissection for superficial esophageal squamous cell carcinoma: a propensity score matching analysis

Cited by 40 publications

References 23 publications

Efficacy and safety of endoscopic submucosal tunnel dissection vs endoscopic submucosal dissection for early superficial upper gastrointestinal precancerous lesions and tumors: A meta‐analysis

Efficacy and safety of endoscopic submucosal tunnel dissection vs endoscopic submucosal dissection for early superficial upper gastrointestinal precancerous lesions and tumors: A meta‐analysis

Efficacy and safety of endoscopic submucosal tunnel dissection for superficial esophageal neoplastic lesions: a systematic review and meta-analysis

Efficacy of Current Traction Techniques for Endoscopic Submucosal Dissection

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