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Surgical Endoscopy
Published in: Surgical Endoscopy 1/2017

01-01-2017 | Review

Efficacy and safety of submucosal tunneling endoscopic resection for upper gastrointestinal submucosal tumors: a systematic review and meta-analysis

Authors: Xiu-He Lv, Chun-Hui Wang, Yan Xie

Published in: Surgical Endoscopy | Issue 1/2017

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Abstract

Background

In recent years, submucosal tunneling endoscopic resection (STER) has emerged as a novel therapeutic endoscopic technique for upper gastrointestinal submucosal tumors (SMTs). The aim of this study was to evaluate the safety and efficacy of STER for upper gastrointestinal SMTs.

Methods

A systematic search of both English and Chinese databases was performed until November 15, 2015. Complete resection and en bloc resection rates were considered the primary outcome measures. Prevalence of complications was considered the secondary outcome measure. A random-effects model was used to generate conservative estimates of the prevalence of the main outcome variables. All data analyses were performed using Meta-Analyst software (version beta 3.13).

Results

A total of 28 studies were included in the final meta-analysis. The pooled complete resection and en bloc resection rates were 97.5 % (95 % CI 96.0–98.5 %) and 94.6 % (95 % CI 91.5–96.7 %), respectively. The common complications associated with STER were air leakage symptoms and perforation. The pooled prevalence of air leakage symptoms was 14.8 % (95 % CI 10.5–20.5 %) for subcutaneous emphysema and pneumomediastinum, 6.1 % (95 % CI 4.0–9.0 %) for pneumothorax and 6.8 % (95 % CI 4.7–9.6 %) for pneumoperitoneum. Additionally, the pooled prevalence of perforation was 5.6 % (95 % CI 3.7–8.2 %). Only a few cases of bleeding were reported in two studies.

Conclusions

STER is a highly feasible and safe treatment option for upper gastrointestinal SMTs.
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Metadata
Title
Efficacy and safety of submucosal tunneling endoscopic resection for upper gastrointestinal submucosal tumors: a systematic review and meta-analysis
Authors
Xiu-He Lv
Chun-Hui Wang
Yan Xie
Publication date
01-01-2017
Publisher
Springer US
Published in
Surgical Endoscopy / Issue 1/2017
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-016-4978-7

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