Safety and efficacy of the EndoRotor device for the treatment of walled-off pancreatic necrosis after EUS-guided cystenterostomy: A systematic review and meta-analysis.
| Autor: | Ramai D; Gastroenterology & Hepatology, University of Utah Health, Salt Lake City, UT, USA., Ahmed Z; Department of Internal Medicine, University of Toledo Medical Center, Toledo, OH, USA., Chandan S; Division of Gastroenterology & Hepatology, CHI Health Creighton University Medical Center, Omaha, NE, USA., Facciorusso A; Section of Gastroenterology, Department of Medical Sciences, University of Foggia, Foggia, Italy., Deliwala SS; Department of Internal Medicine, Michigan State University at Hurley Medical Center, Flint, MI, USA., Alastal Y; Department of Gastroenterology and Hepatology, University of Toledo Medical Center, Toledo, OH, USA., Nawras A; Department of Gastroenterology and Hepatology, University of Toledo Medical Center, Toledo, OH, USA., Maida M; Gastroenterology and Endoscopy Unit, S. Elia-Raimondi Hospital, Caltanissetta, Italy., Barakat MT; Division of Gastroenterology, Stanford University, Stanford, CA, USA., Anderloni A; Digestive Endoscopy Unit, Humanitas Clinical, and Research Center-IRCCS, Milano, Italy., Adler DG; Center for Advanced Therapeutic Endoscopy (CATE), Porter Adventist Hospital/PEAK Gastroenterology, Denver, CO, USA. |
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| Jazyk: | angličtina |
| Zdroj: | Endoscopic ultrasound [Endosc Ultrasound] 2024 May-Jun; Vol. 13 (3), pp. 165-170. Date of Electronic Publication: 2024 Jan 02. |
| DOI: | 10.1097/eus.0000000000000031 |
| Abstrakt: | Debridement of infected walled-off pancreatic necrosis is indicated to treat and prevent sepsis-related multiorgan failure. The aim of this study was to evaluate the efficacy and safety of the EndoRotor-powered endoscopic debridement system to remove solid debris under direct endoscopic visualization. Search strategies were developed for PubMed, EMBASE, and Cochrane Library databases from inception to June 2022, in accordance with Preferred Reporting items for Systematic Reviews and Meta-Analyses and Meta-Analysis of Observational Studies in Epidemiology guidelines. Outcomes of interest included technical success defined as successful use of device for debridement, clinical success defined as complete debridement and cyst resolution, and procedure-related adverse events. A random-effects model was used for analysis, and results were expressed as odds ratio along with 95% confidence interval. A total of 7 studies ( n = 79 patients) were included. The mean walled-off pancreatic necrosis size was 154.6 ± 34.0 mm, whereas the mean procedure time was 71.4 minutes. The mean number of necrosectomy sessions required was 2.2 (range, 1-7). The pooled rate of clinical success was 96% (95% confidence interval, 91%-100%; I 2 = 0%) with a pooled technical success rate of 96% (91%-100%; I 2 = 0%). The pooled procedure-related adverse event rate was 8% (2%-14%; I 2 = 6%), which included procedure-associated bleeding, pneumoperitoneum, peritonitis, pleural effusion, and dislodgement of lumen-apposing metal stents. Our study shows that the novel EndoRotor device seems to be safe and effective for treating pancreatic necrosis. Patients undergoing endoscopic necrosectomy with the EndoRotor seem to require less debridement sessions when compared with studies using conventional instruments. Competing Interests: Douglas G. Adler is the Co-Editor-in-Chief of the journal. This article was subject to the journal's standard procedures, with peer review handled independently of the editor and his research group. (Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc on behalf of Scholar Media Publishing.) |
| Databáze: | MEDLINE |
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