A systematic review of the clinical effectiveness of a novel rigidizing overtube in completing difficult colonoscopies and for challenging colorectal polyp resection

iGIE Pub Date : 2025-03-01 DOI:10.1016/j.igie.2025.01.010
Eleazar E. Montalvan-Sanchez MD , Dalton A. Norwood MD , Diego Izquierdo-Veraza MD , Renato Beas MD , Mirian Ramirez-Rojas MILS , Sergio A. Sánchez-Luna MD , Shajan Peter MD , Douglas R. Morgan MD , Douglas K. Rex MD
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Abstract

Background and Aims

Completing colonoscopy in redundant colons and resecting complex precancerous lesions are 2 challenging areas in the technical performance of colonoscopy. In this study, we conducted a systematic review to assess the clinical success of a rigidizing overtube (ROT) to facilitate completion of difficult colonoscopy insertions and challenging polyp resections.

Methods

We used multiple electronic databases from August 2019 through June 2024 to identify studies evaluating the use of the novel ROT for colonoscopies.

Results

Five studies were included with a total of 163 patients. Three studies evaluated the ROT system in challenging colonoscopies, with a combined cecal intubation rate of 100%. There were no adverse events. Four studies evaluated ROT for challenging colorectal polyp resection. The overall clinical success was 94.7%. Procedure facilitation was reported in 3 studies, with an average of 92.5% facilitation. One study compared endoscopic submucosal dissection (ESD) with and without ROT and reported similar en-bloc resection and curative rates with the use of ROT (92% and 88%, respectively) compared with conventional ESD (96% and 92%, respectively). In other studies that evaluated ROT in the removal of challenging polyps (60 patients), technical success was achieved in all cases.

Conclusions

ROT is safe, shows potential in enhancing the clinical success of completing difficult colonoscopies, and may be useful for facilitating ESD and endoscopic mucosal resection of some colonic lesions. The mechanism of any benefit is likely in reducing looping in the case of previous incomplete colonoscopies and providing stability in the case of the complex resections. Further controlled studies are warranted and needed to confirm benefit.
一种新型刚性覆盖管在完成困难的结肠镜检查和具有挑战性的结直肠息肉切除术中的临床效果的系统回顾
背景与目的完成冗余结肠结肠镜检查和切除复杂的癌前病变是结肠镜检查技术性能中具有挑战性的两个领域。在这项研究中,我们进行了一项系统回顾,以评估刚性管(ROT)的临床成功,以促进完成困难的结肠镜检查插入和挑战性的息肉切除。方法:我们使用2019年8月至2024年6月的多个电子数据库来识别评估新型ROT用于结肠镜检查的研究。结果纳入5项研究,共163例患者。三项研究评估了ROT系统在具有挑战性的结肠镜检查中的应用,合并盲肠插管率为100%。没有不良事件发生。四项研究评估了ROT在结肠息肉切除术中的应用。临床总成功率为94.7%。3项研究报告了手术的便捷性,平均便捷性为92.5%。一项研究比较了内镜下粘膜剥离(ESD)有和没有ROT,并报告了与传统ESD(分别为96%和92%)相比,使用ROT的整体切除和治愈率(分别为92%和88%)相似。在其他研究中,评估了ROT在去除挑战性息肉(60例)中的作用,所有病例都取得了技术上的成功。结论srot是安全的,可提高临床完成困难结肠镜检查的成功率,并可用于促进ESD和内镜下粘膜切除某些结肠病变。任何有益的机制可能是在以前不完全结肠镜检查的情况下减少环,并在复杂切除的情况下提供稳定性。需要进一步的对照研究来证实其益处。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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