Conventional Versus Traction-Assisted Endoscopic Submucosal Dissection for Esophageal, Gastric, and Colorectal Neoplasms: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

• Published in: Curēus (Palo Alto, CA) Vol. 16; no. 3; p. e55645
• Main Authors: Giacobo Nunes, Felipe, Gomes, Igor Logetto Caetité, De Moura, Diogo Turiani Hourneaux, Dominguez, Juan Eduardo G, Fornari, Fernando, Ribeiro, Igor Braga, Peixoto de Oliveira, Guilherme Henrique, de Figueiredo, Sérgio Mazzola P, Bernardo, Wanderley Marques, Hourneaux de Moura, Eduardo G
• Format: Journal Article
• Language: English
• Published: United States Cureus Inc 06-03-2024
• Subjects: Clinical trials; Colorectal cancer; Data collection; Dental floss; Dissection; Endoscopy; Esophagus; Meta-analysis; Stomach; Systematic review; Tumors; Japan; endoscopic submucosal dissection; endoscopy; traction; endoscopic advanced treatment; gastrointestinal endoscopy
• ISSN: 2168-8184; 2168-8184
• DOI: 10.7759/cureus.55645

Endoscopic submucosal dissection (ESD) is increasingly being utilized for the resection of superficial gastrointestinal neoplasms. However, the long procedure time poses a technical challenge for conventional ESD (C-ESD). Traction-assisted ESD (T-ESD) was developed to facilitate the procedure by reducing its duration. This study compares the efficacy and safety of C-ESD versus T-ESD in the treatment of esophageal, gastric, and colorectal neoplasms. Nine randomized controlled trials (RCTs) were analyzed. Traction-assisted ESD exhibited shorter mean dissection times for the esophagus and colorectal regions and lower perforation rates in colorectal cases. No significant differences were observed in en bloc resection or bleeding rates. Traction-assisted ESD proves to be more efficient in mean procedure time for esophageal and colorectal cases and safer in perforation rates for colorectal cases, but similar rates are noted for en bloc resection or bleeding.