Cold-snare endoscopic resection of non-ampullary duodenal adenomas : Systematic review and pooled-analysis
Copyright © 2023. Published by Elsevier Ltd..
BACKGROUND: Mirroring the experience with colonic resections, cold snare-based techniques have been recently proposed for non-ampullary duodenal lesions to reduce the risk of adverse events (AEs). As the duodenal wall is thinner and more vascularized than in the colon, electrocautery-related AEs are relevant issues in this setting.
AIMS: We performed a systematic review with pooled-analysis to evaluate the efficacy and safety of this technique.
METHODS: Electronic databases (Medline, Scopus, EMBASE) were searched up to January 2023. Full articles including patients with duodenal lesions resected by cold-snare technique were eligible. The adverse events (i.e., bleeding, perforation, stricture), complete resection, and recurrence rates were pooled using a random model.
RESULTS: Eleven studies were eligible, providing data on 3137 lesions removed from 233 patients. The overall AE rate for cold snaring was 0.25% (95% CI, 0.19%-0.69%). Among the three studies comparing cold- and hot-snare approaches, procedure-related bleeding rate was significantly lower with cold approach (OR 1.21, 0.51-2.85; p = 0.66). The complete resection rate was 99.40% (95% CI, 98.60%-100%), with a residual/recurrence rate of 12.95% (95% CI, 4.75%-21.16%). On univariate meta-regression, lesion size significantly affected both the adverse events and recurrence risk.
CONCLUSION: Cold-snare resection appears effective and extremely safe for resecting non-ampullary duodenal lesions.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:56 |
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| Enthalten in: |
Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver - 56(2024), 4 vom: 01. März, Seite 656-662 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Spadaccini, Marco [VerfasserIn] |
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Date Completed 25.03.2024 Date Revised 25.03.2024 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.dld.2023.09.013 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM362732744 |
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| 500 | |a Date Revised 25.03.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2023. Published by Elsevier Ltd. | ||
| 520 | |a BACKGROUND: Mirroring the experience with colonic resections, cold snare-based techniques have been recently proposed for non-ampullary duodenal lesions to reduce the risk of adverse events (AEs). As the duodenal wall is thinner and more vascularized than in the colon, electrocautery-related AEs are relevant issues in this setting | ||
| 520 | |a AIMS: We performed a systematic review with pooled-analysis to evaluate the efficacy and safety of this technique | ||
| 520 | |a METHODS: Electronic databases (Medline, Scopus, EMBASE) were searched up to January 2023. Full articles including patients with duodenal lesions resected by cold-snare technique were eligible. The adverse events (i.e., bleeding, perforation, stricture), complete resection, and recurrence rates were pooled using a random model | ||
| 520 | |a RESULTS: Eleven studies were eligible, providing data on 3137 lesions removed from 233 patients. The overall AE rate for cold snaring was 0.25% (95% CI, 0.19%-0.69%). Among the three studies comparing cold- and hot-snare approaches, procedure-related bleeding rate was significantly lower with cold approach (OR 1.21, 0.51-2.85; p = 0.66). The complete resection rate was 99.40% (95% CI, 98.60%-100%), with a residual/recurrence rate of 12.95% (95% CI, 4.75%-21.16%). On univariate meta-regression, lesion size significantly affected both the adverse events and recurrence risk | ||
| 520 | |a CONCLUSION: Cold-snare resection appears effective and extremely safe for resecting non-ampullary duodenal lesions | ||
| 650 | 4 | |a Systematic Review | |
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Foregut | |
| 650 | 4 | |a Prevention | |
| 650 | 4 | |a Safety | |
| 700 | 1 | |a Alfarone, Ludovico |e verfasserin |4 aut | |
| 700 | 1 | |a Facciorusso, Antonio |e verfasserin |4 aut | |
| 700 | 1 | |a Gkolfakis, Paraskevas |e verfasserin |4 aut | |
| 700 | 1 | |a Thoguluva Chandrasekar, Viveksandeep |e verfasserin |4 aut | |
| 700 | 1 | |a Fugazza, Alessandro |e verfasserin |4 aut | |
| 700 | 1 | |a Colombo, Matteo |e verfasserin |4 aut | |
| 700 | 1 | |a Capogreco, Antonio |e verfasserin |4 aut | |
| 700 | 1 | |a Massimi, Davide |e verfasserin |4 aut | |
| 700 | 1 | |a Carrara, Silvia |e verfasserin |4 aut | |
| 700 | 1 | |a Alkandari, Asma |e verfasserin |4 aut | |
| 700 | 1 | |a Bhandari, Pradeep |e verfasserin |4 aut | |
| 700 | 1 | |a Maselli, Roberta |e verfasserin |4 aut | |
| 700 | 1 | |a Hassan, Cesare |e verfasserin |4 aut | |
| 700 | 1 | |a Repici, Alessandro |e verfasserin |4 aut | |
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