CC BY-NC-ND 4.0 · Endosc Int Open 2022; 10(05): E694-E702
DOI: 10.1055/a-1789-0548
Review

Effectiveness and safety of endoscopic submucosal dissection using the pocket creation method in the Japanese population: a systematic review and meta-analysis

Satoshi Shinozaki
1   Shinozaki Medical Clinic, Utsunomiya, Japan
2   Department of Medicine, Division of Gastroenterology, Jichi Medical University, Shimotsuke, Japan
,
Yoshikazu Hayashi
2   Department of Medicine, Division of Gastroenterology, Jichi Medical University, Shimotsuke, Japan
,
Yoshimasa Miura
2   Department of Medicine, Division of Gastroenterology, Jichi Medical University, Shimotsuke, Japan
,
Tomonori Yano
2   Department of Medicine, Division of Gastroenterology, Jichi Medical University, Shimotsuke, Japan
,
Alan Kawarai Lefor
3   Department of Surgery, Jichi Medical University, Shimotsuke, Japan
,
Hironori Yamamoto
2   Department of Medicine, Division of Gastroenterology, Jichi Medical University, Shimotsuke, Japan
› Institutsangaben

Abstract

Background and study aims Endoscopic submucosal dissection (ESD) is a standard method for minimally invasive resection of superficial gastrointestinal tumors. The pocket creation method (PCM) facilitates ESD regardless of location in the gastrointestinal tract. The aim of this systematic review and meta-analysis is to evaluate the effectiveness and safety of ESD for superficial neoplasms in the upper and lower gastrointestinal tract comparing the PCM to the non-PCM.

Methods Randomized controlled, prospective, and retrospective studies comparing the PCM with the non-PCM were included. Outcomes included en bloc resection, R0 resection, dissection speed, delayed bleeding and perforation. Pooled odds ratios (ORs) with 95 % confidence intervals (CIs) using the Mantel-Haenszel random effect model were documented.

Results Eight studies including gastric, duodenal, and colorectal ESD were included. The en bloc resection rate was significantly higher in the PCM group than the non-PCM group (OR 3.87, 95 %CI 1.24–12.10 P = 0.020). The R0 resection rate was significantly higher in the PCM group than the non-PCM group (OR 2.46, 95 %CI 1.14–5.30, P = 0.020). The dissection speed was significantly faster in the PCM group than the non-PCM group (mean difference 3.13, 95 % CI 1.35–4.91, P < 0.001). The rate of delayed bleeding was similar in the two groups (OR 1.13, 95 %CI 0.60–2.15, P = 0.700). The rate of perforation was significantly lower in the PCM group than the non-PCM group (OR 0.34, 95 %CI 0.15–0.76, P = 0.009).

Conclusions The PCM facilitates high-quality, fast and safe colorectal ESD. Further studies are needed regarding the utility of PCM in ESD of the upper gastrointestinal tract.

Supplementary material



Publikationsverlauf

Eingereicht: 12. Juli 2021

Angenommen nach Revision: 10. November 2021

Artikel online veröffentlicht:
13. Mai 2022

© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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  • References

  • 1 Shinozaki S, Hayashi Y, Lefor AK. et al. What is the best therapeutic strategy for colonoscopy of colorectal neoplasia? Future perspectives from the East.. Dig Endosc 2016; 28: 289-295
  • 2 Hayashi Y, Sunada K, Takahashi H. et al. Pocket-creation method of endoscopic submucosal dissection to achieve en bloc resection of giant colorectal subpedunculated neoplastic lesions. Endoscopy 2014; 46: E421-E422
  • 3 Miura Y, Shinozaki S, Hayashi Y. et al. Duodenal endoscopic submucosal dissection is feasible using the pocket-creation method. Endoscopy 2017; 49: 8-14
  • 4 Higgins JP, Altman DG, Gøtzsche PC. et al. The Cochrane Collaboration’s tool for assessing risk of bias in randomised trials. BMJ 2011; 343: d5928
  • 5 Kim SY, Park JE, Lee YJ. et al. Testing a tool for assessing the risk of bias for nonrandomized studies showed moderate reliability and promising validity. J Clin Epidemiol 2013; 66: 408-414
  • 6 Higgins JP, Thompson SG, Deeks JJ. et al. Measuring inconsistency in meta-analyses. BMJ 2003; 327: 557-560
  • 7 Yamashina T, Hayashi Y, Fukuda H. et al. The pocket-creation method may facilitate endoscopic submucosal dissection of large colorectal sessile tumors. Endosc Int Open 2020; 8: E1021-e1030
  • 8 Sakamoto H, Hayashi Y, Miura Y. et al. Pocket-creation method facilitates endoscopic submucosal dissection of colorectal laterally spreading tumors, non-granular type. Endosc Int Open 2017; 5: E123-E129
  • 9 Takezawa T, Hayashi Y, Shinozaki S. et al. The pocket-creation method facilitates colonic endoscopic submucosal dissection (with video). Gastrointest Endosc 2019; 89: 1045-1053
  • 10 Yoshida N, Naito Y, Yasuda R. et al. The efficacy of the pocket-creation method for cases with severe fibrosis in colorectal endoscopic submucosal dissection. Endosc Int Open 2018; 6: e975-e983
  • 11 Kanamori A, Nakano M, Kondo M. et al. Clinical effectiveness of the pocket-creation method for colorectal endoscopic submucosal dissection. Endosc Int Open 2017; 5: e1299-e1305
  • 12 Kitamura M, Miura Y, Shinozaki S. et al. The pocket-creation method facilitates endoscopic submucosal dissection of gastric neoplasms involving the pyloric ring. Endosc Int Open 2021; 9: e1062-e1069
  • 13 Yamashina T, Nemoto D, Hayashi Y. et al. Prospective randomized trial comparing the pocket-creation method and conventional method of colorectal endoscopic submucosal dissection. Gastrointest Endosc 2020; 92: 368-379
  • 14 Harada H, Nakahara R, Murakami D. et al. Saline-pocket endoscopic submucosal dissection for superficial colorectal neoplasms: a randomized controlled trial (with video). Gastrointest Endosc 2019; 90: 278-287
  • 15 Harada H, Murakami D, Suehiro S. et al. Water-pocket endoscopic submucosal dissection for superficial gastric neoplasms (with video). Gastrointest Endosc 2018; 88: 253-260
  • 16 Hotta K, Saito Y, Matsuda T. et al. Local recurrence and surveillance after endoscopic resection of large colorectal tumors. Dig Endosc 2010; 22: S63-S68
  • 17 Pei Q, Qiao H, Zhang M. et al. Pocket-creation method versus conventional method of endoscopic submucosal dissection for superficial colorectal neoplasms: a meta-analysis. Gastrointest Endosc 2021; 93: 1038-1046.e4
  • 18 Gong J, Chen T, Tan Y. et al. Pocket-creation method improves efficacy of colorectal endoscopic submucosal dissection: a system review and meta-analysis. Eur J Gastroenterol Hepatol 2020; 33: 1241-1246
  • 19 Watanabe T, Itabashi M, Shimada Y. et al. Japanese Society for Cancer of the Colon and Rectum (JSCCR) Guidelines 2014 for treatment of colorectal cancer. Int J Clin Oncol 2015; 20: 207-239
  • 20 Abe S, Wu SYS, Ego M. et al. Efficacy of Current traction techniques for endoscopic submucosal dissection. Gut Liver 2020; 14: 673-684