Efficacy and safety of underwater endoscopic mucosal resection for ≤20 mm superficial non-ampullary duodenal epithelial tumors: Systematic review and meta-analysis
Superficial non-ampullary duodenal epithelial tumors (SNADETs) as a rare disease have gradually increased in recent years. Underwater endoscopic mucosal resection (UEMR) has emerged as a newly available option for the endoscopic resection of SNADETs. This study aimed to evaluate the efficacy and saf...
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Published in | Frontiers in medicine Vol. 9; p. 1077806 |
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Abstract | Superficial non-ampullary duodenal epithelial tumors (SNADETs) as a rare disease have gradually increased in recent years. Underwater endoscopic mucosal resection (UEMR) has emerged as a newly available option for the endoscopic resection of SNADETs. This study aimed to evaluate the efficacy and safety of UEMR for ≤20 mm SNADETs.
A literature search was performed across multiple databases, including PubMed, Embase, Scopus, and Clinical trials for studies containing tumors ≤20 mm published from January 1, 2012, to August 8, 2022. Outcomes examined were the pooled rates of en bloc resection, R0 resection, adverse events, and recurrence. Subgroup analyses of the resection rate were conducted stratified by sample size and polyp size.
A total of 10 studies with UEMR performed in a total of 648 tumors were included for analysis. The pooled rate of en bloc resection and R0 resection was 88.2% (95% confidence interval (CI): 82.1-93.2) and 69.1% (95% CI: 62.2-76.1), respectively. The results showed pooled rate of intraoperative bleeding rate was 2.9% (95% CI: 0-9.0), delayed bleeding rate was 0.9% (95% CI: 0.1-2), recurrence rate was 1.5% (95% CI: 0-4.9). In the subgroup analysis, R0 and en-bloc resection rates were significantly higher in <10 mm than 10-20 mm SNADETs subgroups (R0 resection rate 83.1 vs. 48.6%; en bloc resection rate 100.0 vs. 84.0%,
< 0.05).
Underwater endoscopic mucosal resection was an effective and safe technique for the optional treatment for ≤20 mm SNADETs, especially of <10 mm.
https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42022340578. |
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AbstractList | Background and aimsSuperficial non-ampullary duodenal epithelial tumors (SNADETs) as a rare disease have gradually increased in recent years. Underwater endoscopic mucosal resection (UEMR) has emerged as a newly available option for the endoscopic resection of SNADETs. This study aimed to evaluate the efficacy and safety of UEMR for ≤20 mm SNADETs.MethodsA literature search was performed across multiple databases, including PubMed, Embase, Scopus, and Clinical trials for studies containing tumors ≤20 mm published from January 1, 2012, to August 8, 2022. Outcomes examined were the pooled rates of en bloc resection, R0 resection, adverse events, and recurrence. Subgroup analyses of the resection rate were conducted stratified by sample size and polyp size.ResultsA total of 10 studies with UEMR performed in a total of 648 tumors were included for analysis. The pooled rate of en bloc resection and R0 resection was 88.2% (95% confidence interval (CI): 82.1–93.2) and 69.1% (95% CI: 62.2–76.1), respectively. The results showed pooled rate of intraoperative bleeding rate was 2.9% (95% CI: 0–9.0), delayed bleeding rate was 0.9% (95% CI: 0.1–2), recurrence rate was 1.5% (95% CI: 0–4.9). In the subgroup analysis, R0 and en-bloc resection rates were significantly higher in <10 mm than 10–20 mm SNADETs subgroups (R0 resection rate 83.1 vs. 48.6%; en bloc resection rate 100.0 vs. 84.0%, P < 0.05).ConclusionUnderwater endoscopic mucosal resection was an effective and safe technique for the optional treatment for ≤20 mm SNADETs, especially of <10 mm.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/, identifier CRD42022340578. Superficial non-ampullary duodenal epithelial tumors (SNADETs) as a rare disease have gradually increased in recent years. Underwater endoscopic mucosal resection (UEMR) has emerged as a newly available option for the endoscopic resection of SNADETs. This study aimed to evaluate the efficacy and safety of UEMR for ≤20 mm SNADETs. A literature search was performed across multiple databases, including PubMed, Embase, Scopus, and Clinical trials for studies containing tumors ≤20 mm published from January 1, 2012, to August 8, 2022. Outcomes examined were the pooled rates of en bloc resection, R0 resection, adverse events, and recurrence. Subgroup analyses of the resection rate were conducted stratified by sample size and polyp size. A total of 10 studies with UEMR performed in a total of 648 tumors were included for analysis. The pooled rate of en bloc resection and R0 resection was 88.2% (95% confidence interval (CI): 82.1-93.2) and 69.1% (95% CI: 62.2-76.1), respectively. The results showed pooled rate of intraoperative bleeding rate was 2.9% (95% CI: 0-9.0), delayed bleeding rate was 0.9% (95% CI: 0.1-2), recurrence rate was 1.5% (95% CI: 0-4.9). In the subgroup analysis, R0 and en-bloc resection rates were significantly higher in <10 mm than 10-20 mm SNADETs subgroups (R0 resection rate 83.1 vs. 48.6%; en bloc resection rate 100.0 vs. 84.0%, < 0.05). Underwater endoscopic mucosal resection was an effective and safe technique for the optional treatment for ≤20 mm SNADETs, especially of <10 mm. https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42022340578. Background and aims Superficial non-ampullary duodenal epithelial tumors (SNADETs) as a rare disease have gradually increased in recent years. Underwater endoscopic mucosal resection (UEMR) has emerged as a newly available option for the endoscopic resection of SNADETs. This study aimed to evaluate the efficacy and safety of UEMR for ≤20 mm SNADETs. Methods A literature search was performed across multiple databases, including PubMed, Embase, Scopus, and Clinical trials for studies containing tumors ≤20 mm published from January 1, 2012, to August 8, 2022. Outcomes examined were the pooled rates of en bloc resection, R0 resection, adverse events, and recurrence. Subgroup analyses of the resection rate were conducted stratified by sample size and polyp size. Results A total of 10 studies with UEMR performed in a total of 648 tumors were included for analysis. The pooled rate of en bloc resection and R0 resection was 88.2% (95% confidence interval (CI): 82.1–93.2) and 69.1% (95% CI: 62.2–76.1), respectively. The results showed pooled rate of intraoperative bleeding rate was 2.9% (95% CI: 0–9.0), delayed bleeding rate was 0.9% (95% CI: 0.1–2), recurrence rate was 1.5% (95% CI: 0–4.9). In the subgroup analysis, R0 and en-bloc resection rates were significantly higher in <10 mm than 10–20 mm SNADETs subgroups (R0 resection rate 83.1 vs. 48.6%; en bloc resection rate 100.0 vs. 84.0%, P < 0.05). Conclusion Underwater endoscopic mucosal resection was an effective and safe technique for the optional treatment for ≤20 mm SNADETs, especially of <10 mm. Systematic review registration https://www.crd.york.ac.uk/PROSPERO/ , identifier CRD42022340578. |
Author | Wang, Yichong Yao, Shukun Peng, Hongye Duan, Shaojie Kong, Youjia Liu, Jixiang |
AuthorAffiliation | 2 Department of Gastroenterology, China-Japan Friendship Hospital , Beijing , China 1 Graduate School of Beijing University of Chinese Medicine , Beijing , China 3 Beijing Hospital of Traditional Chinese Medicine Affiliated to Capital Medical University , Beijing , China |
AuthorAffiliation_xml | – name: 3 Beijing Hospital of Traditional Chinese Medicine Affiliated to Capital Medical University , Beijing , China – name: 2 Department of Gastroenterology, China-Japan Friendship Hospital , Beijing , China – name: 1 Graduate School of Beijing University of Chinese Medicine , Beijing , China |
Author_xml | – sequence: 1 givenname: Jixiang surname: Liu fullname: Liu, Jixiang organization: Department of Gastroenterology, China-Japan Friendship Hospital, Beijing, China – sequence: 2 givenname: Shaojie surname: Duan fullname: Duan, Shaojie organization: Department of Gastroenterology, China-Japan Friendship Hospital, Beijing, China – sequence: 3 givenname: Yichong surname: Wang fullname: Wang, Yichong organization: Beijing Hospital of Traditional Chinese Medicine Affiliated to Capital Medical University, Beijing, China – sequence: 4 givenname: Hongye surname: Peng fullname: Peng, Hongye organization: Department of Gastroenterology, China-Japan Friendship Hospital, Beijing, China – sequence: 5 givenname: Youjia surname: Kong fullname: Kong, Youjia organization: Department of Gastroenterology, China-Japan Friendship Hospital, Beijing, China – sequence: 6 givenname: Shukun surname: Yao fullname: Yao, Shukun organization: Department of Gastroenterology, China-Japan Friendship Hospital, Beijing, China |
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Keywords | underwater endoscopic mucosal resection non-ampullary adenoma safety duodenum efficacy |
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Notes | content type line 23 SourceType-Scholarly Journals-1 Edited by: Zikai Wang, People’s Liberation Army General Hospital, China Reviewed by: Rongrong Ren, People’s Liberation Army General Hospital, China; Shuling Li, First Medical Center of PLA General Hospital, China This article was submitted to Gastroenterology, a section of the journal Frontiers in Medicine |
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Snippet | Superficial non-ampullary duodenal epithelial tumors (SNADETs) as a rare disease have gradually increased in recent years. Underwater endoscopic mucosal... Background and aims Superficial non-ampullary duodenal epithelial tumors (SNADETs) as a rare disease have gradually increased in recent years. Underwater... Background and aimsSuperficial non-ampullary duodenal epithelial tumors (SNADETs) as a rare disease have gradually increased in recent years. Underwater... |
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StartPage | 1077806 |
SubjectTerms | duodenum efficacy Medicine non-ampullary adenoma safety underwater endoscopic mucosal resection |
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Title | Efficacy and safety of underwater endoscopic mucosal resection for ≤20 mm superficial non-ampullary duodenal epithelial tumors: Systematic review and meta-analysis |
URI | https://www.ncbi.nlm.nih.gov/pubmed/36687419 https://search.proquest.com/docview/2768810332 https://pubmed.ncbi.nlm.nih.gov/PMC9853979 https://doaj.org/article/0a354f8eaae44decacb02231580dab80 |
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