Pedro Henrique Veras Ayres da Silva, Angelo So Taa Kum, Igor Logetto Caetité Gomes, Nelson Tomio Miyajima, Alexandre Moraes Bestetti, Diego Paul Cadena Aguirre, Megui Marilia Mansilla Gallegos, Hiram Menezes Nascimento Filho, Igor Valdeir Gomes de Sousa, Wanderley Marques Bernardo, Eduardo Guimarães Hourneaux de Moura
{"title":"剪刀辅助与传统内镜黏膜下剥离术治疗结直肠病变：系统回顾和荟萃分析。","authors":"Pedro Henrique Veras Ayres da Silva, Angelo So Taa Kum, Igor Logetto Caetité Gomes, Nelson Tomio Miyajima, Alexandre Moraes Bestetti, Diego Paul Cadena Aguirre, Megui Marilia Mansilla Gallegos, Hiram Menezes Nascimento Filho, Igor Valdeir Gomes de Sousa, Wanderley Marques Bernardo, Eduardo Guimarães Hourneaux de Moura","doi":"10.1111/den.14829","DOIUrl":null,"url":null,"abstract":"<div>\n \n <section>\n \n <h3> Objectives</h3>\n \n <p>Colorectal endoscopic submucosal dissection (ESD) is a technically complex procedure. The scissor knife mechanism may potentially provide easier and safer colorectal ESD. The aim of this meta-analysis is to evaluate the efficacy and safety of scissor-assisted vs. conventional ESD for colorectal lesions.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>A search strategy was conducted in MEDLINE, Embase, and Lilacs databases from January 1990 to November 2023 according to PRISMA guidelines. Fixed and random-effects models were used for statistical analysis. Heterogeneity was assessed using <i>I</i><sup>2</sup> test. Risk of bias was assessed using the ROBINS-I and RoB-2 tools. Quality of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation tool.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>A total of five studies (three retrospective and two randomized controlled trials, including a total of 1575 colorectal ESD) were selected. The intraoperative perforation rate was statistically lower (risk difference [RD] −0.02; 95% confidence interval [CI] −0.04 to −0.01; <i>P</i> = 0.001; <i>I</i><sup>2</sup> = 0%) and the self-completion rate was statistically higher (RD 0.14; 95% CI 0.06, 0.23; <i>P</i> = 0.0006; <i>I</i><sup>2</sup> = 0%) in the scissor-assisted group compared with the conventional ESD group. There was no statistical difference in R0 resection rate, en bloc resection rate, mean procedure time, or delayed bleeding rate between the groups.</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>Scissor knife-assisted ESD is as effective as conventional knife-assisted ESD for colorectal lesions with lower intraoperative perforation rate and a higher self-completion rate.</p>\n </section>\n </div>","PeriodicalId":159,"journal":{"name":"Digestive Endoscopy","volume":"36 11","pages":"1213-1224"},"PeriodicalIF":5.0000,"publicationDate":"2024-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Scissor-assisted vs. conventional endoscopic submucosal dissection for colorectal lesions: Systematic review and meta-analysis\",\"authors\":\"Pedro Henrique Veras Ayres da Silva, Angelo So Taa Kum, Igor Logetto Caetité Gomes, Nelson Tomio Miyajima, Alexandre Moraes Bestetti, Diego Paul Cadena Aguirre, Megui Marilia Mansilla Gallegos, Hiram Menezes Nascimento Filho, Igor Valdeir Gomes de Sousa, Wanderley Marques Bernardo, Eduardo Guimarães Hourneaux de Moura\",\"doi\":\"10.1111/den.14829\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n <section>\\n \\n <h3> Objectives</h3>\\n \\n <p>Colorectal endoscopic submucosal dissection (ESD) is a technically complex procedure. The scissor knife mechanism may potentially provide easier and safer colorectal ESD. The aim of this meta-analysis is to evaluate the efficacy and safety of scissor-assisted vs. conventional ESD for colorectal lesions.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>A search strategy was conducted in MEDLINE, Embase, and Lilacs databases from January 1990 to November 2023 according to PRISMA guidelines. Fixed and random-effects models were used for statistical analysis. Heterogeneity was assessed using <i>I</i><sup>2</sup> test. Risk of bias was assessed using the ROBINS-I and RoB-2 tools. Quality of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation tool.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>A total of five studies (three retrospective and two randomized controlled trials, including a total of 1575 colorectal ESD) were selected. The intraoperative perforation rate was statistically lower (risk difference [RD] −0.02; 95% confidence interval [CI] −0.04 to −0.01; <i>P</i> = 0.001; <i>I</i><sup>2</sup> = 0%) and the self-completion rate was statistically higher (RD 0.14; 95% CI 0.06, 0.23; <i>P</i> = 0.0006; <i>I</i><sup>2</sup> = 0%) in the scissor-assisted group compared with the conventional ESD group. 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Scissor-assisted vs. conventional endoscopic submucosal dissection for colorectal lesions: Systematic review and meta-analysis
Objectives
Colorectal endoscopic submucosal dissection (ESD) is a technically complex procedure. The scissor knife mechanism may potentially provide easier and safer colorectal ESD. The aim of this meta-analysis is to evaluate the efficacy and safety of scissor-assisted vs. conventional ESD for colorectal lesions.
Methods
A search strategy was conducted in MEDLINE, Embase, and Lilacs databases from January 1990 to November 2023 according to PRISMA guidelines. Fixed and random-effects models were used for statistical analysis. Heterogeneity was assessed using I2 test. Risk of bias was assessed using the ROBINS-I and RoB-2 tools. Quality of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation tool.
Results
A total of five studies (three retrospective and two randomized controlled trials, including a total of 1575 colorectal ESD) were selected. The intraoperative perforation rate was statistically lower (risk difference [RD] −0.02; 95% confidence interval [CI] −0.04 to −0.01; P = 0.001; I2 = 0%) and the self-completion rate was statistically higher (RD 0.14; 95% CI 0.06, 0.23; P = 0.0006; I2 = 0%) in the scissor-assisted group compared with the conventional ESD group. There was no statistical difference in R0 resection rate, en bloc resection rate, mean procedure time, or delayed bleeding rate between the groups.
Conclusion
Scissor knife-assisted ESD is as effective as conventional knife-assisted ESD for colorectal lesions with lower intraoperative perforation rate and a higher self-completion rate.
期刊介绍：
Digestive Endoscopy (DEN) is the official journal of the Japan Gastroenterological Endoscopy Society, the Asian Pacific Society for Digestive Endoscopy and the World Endoscopy Organization. Digestive Endoscopy serves as a medium for presenting original articles that offer significant contributions to knowledge in the broad field of endoscopy. The Journal also includes Reviews, Original Articles, How I Do It, Case Reports (only of exceptional interest and novelty are accepted), Letters, Techniques and Images, abstracts and news items that may be of interest to endoscopists.
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