Endoscopic needle‐knife treatment for symptomatic esophageal Zenker’s diverticulum: A meta‐analysis and systematic review
OBJECTIVE The aim of this study was to assess the efficacy and safety following endoscopic management of Zenker’s diverticulum (ZD) using a needle‐knife technique. METHODS A systematic search of PubMed, Embase and Cochrane library databases was performed. All original studies reporting efficacy and...
Saved in:
Published in | Journal of digestive diseases Vol. 19; no. 4; pp. 204 - 214 |
---|---|
Main Authors | , , , , , , , , , |
Format | Journal Article |
Language | English |
Published |
Melbourne
Wiley Publishing Asia Pty Ltd
01.04.2018
Wiley Subscription Services, Inc |
Subjects | |
Online Access | Get full text |
Cover
Loading…
Summary: | OBJECTIVE
The aim of this study was to assess the efficacy and safety following endoscopic management of Zenker’s diverticulum (ZD) using a needle‐knife technique.
METHODS
A systematic search of PubMed, Embase and Cochrane library databases was performed. All original studies reporting efficacy and safety of needle‐knife technique for treatment of ZD were included. Pooled event rates across studies were expressed with summative statistics. Main outcomes, such as rates of immediate symptomatic response (ISR), adverse events and recurrence, were extracted, pooled and analyzed. Heterogeneity among studies was assessed using the R statistic. The random effects model was used and results were expressed with forest plots and summative statistics.
RESULTS
Thirteen studies included 589 patients were enrolled. Pooled event rates for ISR, overall complication, bleeding and perforation were 88% (95% confidence interval [CI] 79–94%), 13% (95% CI 8–22%), 5% (95% CI 3–10%) and 7% (95% CI 4–12%), respectively. The pooled data demonstrated an overall recurrence rate of 14% (95% CI 9–21%). Diverticulum size of at least 4 cm and less than 4 cm demonstrated pooled adverse event rates of 17% (95% CI 10–27%) and 7% (95% CI 2–18%), respectively. When using diverticuloscope as an accessory, pooled ISR and adverse events rates were 84% (95% CI 58–95%) and 10% (95% CI 3–26%), respectively.
CONCLUSION
Flexible endoscopic procedures using needle‐knife offers a relatively safe and effective treatment of symptomatic ZD, especially for ZD of <4 cm in diameter. |
---|---|
Bibliography: | ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Feature-1 ObjectType-Review-4 content type line 23 ObjectType-Undefined-3 |
ISSN: | 1751-2972 1751-2980 |
DOI: | 10.1111/1751-2980.12588 |