Gastrointestinal endoscopy · 2025
Efficacy and safety of repeat endoscopic submucosal dissection for recurrent, synchronous, and metachronous esophageal squamous cell carcinoma: a systematic review and meta-analysis.
СтатьяСистематический обзорМетаанализПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Ошибки и ограничения
История · было → стало
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Kalsi Harsimran, Rai Anushree, Arora Samneet Singh, Singh Sahib, Brar Tony S, Perbtani Yaseen, Mohan Babu P
Аннотация
BACKGROUND AND AIMS: Endoscopic submucosal dissection (ESD) is the preferred treatment for early-stage esophageal squamous cell carcinoma (ESCC), providing a minimally invasive endoscopic alternative to surgery with potential for complete resection and organ preservation. This study aims to evaluate the efficacy and safety of repeat ESD for recurrent ESCC lesions located on or near previous ESD scars.
METHODS: A systematic search of PubMed, Google Scholar, and Cochrane (from inception to November 2024) identified studies on repeat ESD for recurrent ESCC near previous ESD scars. Primary outcomes were en bloc resection and complete resection. Secondary outcomes included adverse events (perforation, stricture, bleeding) and recurrence. Meta-analysis was conducted using a random-effects model, and heterogeneity was assessed with I2 statistics.
RESULTS: Five studies with 232 patients (mean age 69.4 years; 85.35% male) and 258 lesions were analyzed. The pooled en bloc resection rate was 90.07% (95% CI, 82.46-95.70; I2 = 67.77%), and the complete resection rate was 79.59% (95% CI, 67.71-89.31; I2 = 66.93%). Adverse event rates included perforation at 5.21%, stricture at 10.26%, and delayed bleeding rate of 4.05%. Recurrence after repeat ESD was 8.60% (95% CI, 3.08-16.53; I2 = 72.66%).
CONCLUSIONS: Repeat ESD demonstrated acceptable clinical outcomes for recurrent ESCC. Despite technical challenges and variability in adverse events, it seems to be a viable endoscopic option, emphasizing the need for further research to optimize outcomes.
METHODS: A systematic search of PubMed, Google Scholar, and Cochrane (from inception to November 2024) identified studies on repeat ESD for recurrent ESCC near previous ESD scars. Primary outcomes were en bloc resection and complete resection. Secondary outcomes included adverse events (perforation, stricture, bleeding) and recurrence. Meta-analysis was conducted using a random-effects model, and heterogeneity was assessed with I2 statistics.
RESULTS: Five studies with 232 patients (mean age 69.4 years; 85.35% male) and 258 lesions were analyzed. The pooled en bloc resection rate was 90.07% (95% CI, 82.46-95.70; I2 = 67.77%), and the complete resection rate was 79.59% (95% CI, 67.71-89.31; I2 = 66.93%). Adverse event rates included perforation at 5.21%, stricture at 10.26%, and delayed bleeding rate of 4.05%. Recurrence after repeat ESD was 8.60% (95% CI, 3.08-16.53; I2 = 72.66%).
CONCLUSIONS: Repeat ESD demonstrated acceptable clinical outcomes for recurrent ESCC. Despite technical challenges and variability in adverse events, it seems to be a viable endoscopic option, emphasizing the need for further research to optimize outcomes.