Clinical Endoscopy

The Korean Society of Gastrointestinal Endoscopy (대한소화기내시경학회)
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Comparison of scissor-type knife to non-scissor-type knife for endoscopic submucosal dissection: a systematic review and meta-analysis

  • Harishankar Gopakumar (Department of Gastroenterology and Hepatology, University of Illinois College of Medicine at Peoria) ;
  • Ishaan Vohra (Department of Gastroenterology and Hepatology, University of Illinois College of Medicine at Peoria) ;
  • Srinivas Reddy Puli (Department of Gastroenterology and Hepatology, University of Illinois College of Medicine at Peoria) ;
  • Neil R Sharma (Interventional Oncology & Surgical Endoscopy (IOSE) Division, GI Oncology Tumor Site Team, Parkview Cancer Institute)
  • Received : 2023.05.07
  • Accepted : 2023.06.16
  • Published : 2024.01.30
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Abstract

Background/Aims: Scissor-type endoscopic submucosal dissection (ST-ESD) knives can reduce the adverse events associated with ESDs. This study aimed to compare ST-ESD and non-scissor-type (NST)-ESD knives. Methods: We identified ten studies that compared the performance characteristics and safety profiles of ST-ESD and NST-ESD knives. Fixed- and random-effects models were used to calculate the pooled proportions. Heterogeneity was assessed using the I2 test. Results: On comparing ST-ESD knives to NST-ESD knives, the weighted odds of en bloc resection was 1.61 (95% confidence interval [CI], 0.90-2.90; p=0.14), R0 resection was 1.10 (95% CI, 0.71-1.71; p=0.73), delayed bleeding was 0.40 (95% CI, 0.17-0.90; p=0.03), perforation was 0.35 (95% CI, 0.18-0.70; p<0.01) and ESD self-completion by non-experts was 1.89 (95% CI, 1.20-2.95; p<0.01). There was no heterogeneity, with an I2 score of 0% (95% CI, 0%-54.40%). Conclusions: The findings of reduced odds of perforation, a trend toward reduced delayed bleeding, and an improvement in the rates of en bloc and R0 resection with ST-ESD knives compared to NST-ESD knives support the use of ST-ESD knives when non-experts perform ESDs or as an adjunct tool for challenging ESD procedures.

Keywords

References

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