Safety and Efficacy of Powered Non-Thermal Endoscopic Resection Device for Removal of Colonic Polyps: A Systematic Review and Meta-Analysis.
| Autor: | Ahmed Z; Department of Gastroenterology and Hepatology, University of Toledo Medical Center, Toledo, OH, USA., Ramai D; Department of Gastroenterology and Hepatology, University of Utah School of Medicine, Salt Lake City, UT, USA., Merza N; Department of Internal Medicine, University of Toledo Medical Center, Toledo, OH, USA., Badal J; University of Toledo College of Medicine and Life Sciences, Toledo, OH, USA., Iqbal U; Department of Gastroenterology and Hepatology, Geisinger Medical Center, Danville, PA, USA., Arif SF; Dow Medical University, Karachi, Pakistan., Al-Hillan A; Gastroenterology Department, Corewell Health/Willam Beaumont University Hospital, Royal Oak, MI, USA., Varughese T; Department of Internal Medicine, Hackensack University Medical Center, Hackensack, NJ, USA., Lee-Smith W; University of Toledo Libraries, University of Toledo, Toledo, OH, USA., Nawras A; Division of Gastroenterology and Hepatology, University of Toledo, Toledo, OH, USA., Alastal Y; Division of Gastroenterology and Hepatology, University of Toledo, Toledo, OH, USA., Khara HS; Department of Gastroenterology and Hepatology, Geisinger Medical Center, Danville, PA, USA., Confer BD; Department of Gastroenterology and Hepatology, Geisinger Medical Center, Danville, PA, USA., Diehl DL; Department of Gastroenterology and Hepatology, Geisinger Medical Center, Danville, PA, USA., Adler DG; Center for Advanced Therapeutic Endoscopy, Porter Adventist Hospital, Centura Health, Denver, CO, USA. |
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| Jazyk: | angličtina |
| Zdroj: | Gastroenterology research [Gastroenterology Res] 2023 Oct; Vol. 16 (5), pp. 254-261. Date of Electronic Publication: 2023 Oct 21. |
| DOI: | 10.14740/gr1638 |
| Abstrakt: | Background: Endoscopic mucosal resection is a frequently employed method for removing colonic polyps. Nonetheless, the recurrence of these polyps over a healed submucosal base can complicate the extraction of leftover lesions through standard procedures. EndoRotor ® , a non-thermal device specifically designed for endoscopic mucosal resection, has recently been assessed for its utility in removing colonic polyps, non-dysplastic Barrett's esophagus, and pancreatic necrosis. We conducted a systematic review and meta-analysis to ascertain the safety and efficacy of EndoRotor ® in resecting scared or recurrence colonic polyps. Methods: We conducted an exhaustive review of existing literature using databases such as Medline, Embase, Web of Science, and the Cochrane Library until January 2023. Our aim was to find all studies that assessed the safety of non-thermal endoscopic resection devices in removing colonic polyps. The primary outcome we focused on was the rate of technical success. Secondary outcomes that we considered included the frequency of remaining lesions and instances of adverse events. To analyze these data, we used comprehensive meta-analysis software. Results: Our analysis incorporated three studies comprising 54 patients who underwent resection of 60 lesions. The combined technical success rate was 93.9% (95% confidence interval (CI): 77.7-98.6%, I 2 = 25.5%). In patients who had another endoscopic examination, 20 were found to have a residual lesion. After the initial session, the combined rate of remaining lesions was 39.8% (95% CI: 15.3-70.8%, I 2 = 74.5%). There were eight occurrences of intraoperative bleeding and four instances of bleeding post-procedure. The combined rate of intraoperative bleeding was 13.2% (95% CI: 6.7-24.3%, I 2 = 0%), and post-procedure bleeding stood at 8.5% (95% CI: 3.4-19.8%, I 2 = 0%). Only one major bleeding event was recorded, and no cases of perforation were reported. Conclusion: Our research indicates that the EndoRotor ® effectively removes scarred colonic polyps, though the rate of remaining lesions is significant, potentially necessitating several sessions for a thorough removal. There is a need for broader prospective studies, mainly randomized controlled trials, to further assess EndoRotor ® 's efficiency and safety in eliminating colonic polyps. Competing Interests: The authors declare that they have no conflict of interest. (Copyright 2023, Ahmed et al.) |
| Databáze: | MEDLINE |
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