A meta-analysis of safety and efficacy of endoscopic submucosal tunnel dissection for esophageal submucosal tumors / 中华消化内镜杂志

ABSTRACT

Objective To evaluate the safety and efficacy of endoscopic submucosal tunnel dissection (ESTD) for esophageal submucosal tumors (SMTs). Methods A meta-analysis was performed on 18 related studies of ESTD on the treatment of esophageal SMTs retrieving from Chinese and English databases. Complete resection rate and en bloc resection rate were extracted for efficacy, and the complication rate, recurrence rate and death were used to evaluate safety. Results Complete resection rate was reported in all studies, and the pooled complete resection rate was 97. 5%(95%CI 95. 4%-98. 6%). There were 9 studies that reported en bloc resection rate, and the pooled en bloc resection rate was 95. 9%(95%CI90. 1%-98. 3%). Subcutaneous emphysema, mediastinal emphysema, pneumothorax, pneumoper-itoneum and perforation were reported in all 18 studies. The pooled prevalence of air leakage symptoms was 11. 3%(95%CI 7. 0%-17. 6%) for subcutaneous emphysema and pneumomediastinum, 3. 6%( 95%CI2. 1%-6. 2%) for pneumothorax and 3. 2%( 95%CI 1. 9%-5. 4%) for pneumoperitoneum. Additionally, the pooled prevalence of perforation was 4. 9%(95%CI 3. 1%-7. 8%).Intraoperative bleeding was reported in 2 studies, and the pooled incidence of bleeding was 3. 7%(95%CI 2. 1%-6. 4%). During the follow-up of the 18 studies, no death was reported, and only 2 cases of recurrence were reported in one study. Conclusion ESTD is safe and effective for esophageal SMTs.