Efficacy of endoscopic submucosal tunnel dissection versus endoscopic submucosal dissection for superficial esophageal neoplastic lesions: a systematic review and meta-analysis. 2021

Ting Zhang, and Hao Zhang, and Furui Zhong, and Xuan Wang
Department of Gastroenterology, Affiliated Hospital of Southwest Medical University, 25 Taiping street, Luzhou, Sichuan Province, 646000, People's Republic of China.

To evaluate the effectiveness of endoscopic submucosal tunnel dissection (ESTD) and endoscopic submucosal dissection (ESD) in superficial esophageal neoplastic lesions (SENL). A comprehensive search for studies investigating the efficacy of ESTD and ESD for SENL was conducted to search for relevant studies through PubMed, Web of Science, Cochrane Library, SinoMed, CNKI, and Wanfang. Weighted pooled rates were calculated for en bloc resection rate, R0 resection rate, operation time, dissection area, dissection speed, and adverse events. The 95% confidence intervals (95%CI) for effect size were used to calculate the pooled value using the fixed- or random-effects model. A total of seventeen studies with 1161 patients were identified and included in the meta-analysis. The pooled analysis showed that ESTD had significantly higher en bloc resection (OR 3.98; 95% CI 1.74 to 9.12; p = 0.001) and R0 resection rates (OR 2.29; 95% CI 1.54 to 3.46; p < 0.001) than ESD. The operation time in the ESTD group was shorter than that in the ESD group (SMD = - 0.57; 95% CI - 0.95 to - 0.19; p = 0.003). The dissection area of the ESTD group was larger than that in the ESD group (SMD = 0.49; 95% CI 0.16 to 0.83; p = 0.004), and the dissection speed is faster than that in the ESD group (SMD = 1.52; 95%CI 1.09 to 0.83; p < 0.001). There were no significant differences in esophageal stenosis (p = 0.94) between the two techniques. However, ESTD was superior to ESD in other adverse events (p < 0.05). ESTD has a significant advantage over ESD in the treatment of SENL. ESTD has significantly higher en bloc and R0 resection rates and reduced adverse events.

UI MeSH Term Description Entries
D004938 Esophageal Neoplasms Tumors or cancer of the ESOPHAGUS. Cancer of Esophagus,Esophageal Cancer,Cancer of the Esophagus,Esophagus Cancer,Esophagus Neoplasm,Neoplasms, Esophageal,Cancer, Esophageal,Cancer, Esophagus,Cancers, Esophageal,Cancers, Esophagus,Esophageal Cancers,Esophageal Neoplasm,Esophagus Cancers,Esophagus Neoplasms,Neoplasm, Esophageal,Neoplasm, Esophagus,Neoplasms, Esophagus
D004940 Esophageal Stenosis A stricture of the ESOPHAGUS. Most are acquired but can be congenital. Esophageal Stricture,Stenosis, Esophageal,Esophageal Stenoses,Stricture, Esophageal
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000069916 Endoscopic Mucosal Resection A method for removing lesions from gastrointestinal MUCOUS MEMBRANES. The mucosal tissue with the lesion is elevated by injecting a solution into the submucosal layer underneath it. The elevated tissue with the lesion is then cut out. Endoscopic Full Thickness Resection,Submucosal Tunneling Endoscopic Resection,Endoscopic Mucous Membrane Resection,Endoscopic Submucosal Dissection,Strip Biopsy,Biopsy, Strip,Dissection, Endoscopic Submucosal,Endoscopic Mucosal Resections,Endoscopic Submucosal Dissections,Mucosal Resection, Endoscopic,Resection, Endoscopic Mucosal,Strip Biopsies,Submucosal Dissection, Endoscopic
D016208 Databases, Factual Extensive collections, reputedly complete, of facts and data garnered from material of a specialized subject area and made available for analysis and application. The collection can be automated by various contemporary methods for retrieval. The concept should be differentiated from DATABASES, BIBLIOGRAPHIC which is restricted to collections of bibliographic references. Databanks, Factual,Data Banks, Factual,Data Bases, Factual,Data Bank, Factual,Data Base, Factual,Databank, Factual,Database, Factual,Factual Data Bank,Factual Data Banks,Factual Data Base,Factual Data Bases,Factual Databank,Factual Databanks,Factual Database,Factual Databases
D016896 Treatment Outcome Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, and practicability of these interventions in individual cases or series. Rehabilitation Outcome,Treatment Effectiveness,Clinical Effectiveness,Clinical Efficacy,Patient-Relevant Outcome,Treatment Efficacy,Effectiveness, Clinical,Effectiveness, Treatment,Efficacy, Clinical,Efficacy, Treatment,Outcome, Patient-Relevant,Outcome, Rehabilitation,Outcome, Treatment,Outcomes, Patient-Relevant,Patient Relevant Outcome,Patient-Relevant Outcomes
D061646 Operative Time The duration of a surgical procedure in hours and minutes. Length of Operative Time,Surgical Time,Time Length of Surgery,Operative Time Length,Operative Time Lengths,Operative Times,Surgery Time Length,Surgery Time Lengths,Surgical Times,Time Length, Operative,Time Lengths, Operative,Time, Operative,Time, Surgical,Times, Operative,Times, Surgical

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