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- W3033766051 abstract "Full-thickness resection device (FTRD) utilizes an over-the-scope distal attachment device designed to perform endoscopic full-thickness resections (EFTRs) within the gastrointestinal (GI) tract. FTRD is increasingly used for the removal of lesions not amenable to traditional endoscopic techniques. Initial studies have shown promising but variable results. We conducted a systematic review and meta-analysis to evaluate the safety and efficacy of FTRD for EFTRs in the GI tract. Bibliographical databases (PubMed, Ovid, Scopus, EMBASE, Web of Science, Cochrane and Google scholar) were systematically searched to identify studies using FTRD for EFTR in the GI tract. In addition, abstracts published at major gastroenterology conferences within the last two years were also searched. Studies with < 10 patients and overlapping patients were excluded. The primary outcomes were the rate of technical success and histologically confirmed complete resection (R0). The secondary outcome was rate of adverse events. The pooled estimates with 95% confidence interval were computed using the random-effects model. I-square (I2) statistic was used to quantify heterogeneity. Fifteen studies with a total of 1752 patients were included in the final analysis. There were six prospective studies, eight retrospective studies, and one mixed study. The mean age ranged from 59.7 to 70 years, and 60% of patients were male. The most common indications for EFTR were recurrence or incomplete resection after prior polypectomy (50.7%), followed by primary non-lifting adenoma (17.8%), known intramucosal cancer (9.9%), submucosal lesions (9.2%) and lesions involving appendicular orifice (6.6%). The overall pooled technical success rate was 88.3% (95% CI: 0.86-0.89, I2=0%) and the most common reason reported for technical failure was snare malfunction or clip mis-deployment in 7.1% of cases. Overall pooled R0 resection rate was 78.9% [Figure 1] (95% CI: 0.75-0.82, I2=36.2%). The pooled incidence of the adverse event rate was 12.3% [Figure 2] (95% CI: 0.09-0.15, I2=32.6%). Most adverse events were minor; however, 1.9% patients required surgery for management of procedure-related complications such as perforation, stenosis, and appendicitis. FTRD appears to be an effective and overall safe modality for endoscopic full-thickness resection for lesions not amenable to traditional endoscopic resection techniques sparing formal surgical resection. Future studies regarding learning curve and cost-effectiveness analysis may aid in further adoption of EFTR in the GI tract.Figure 2Forest plot of adverse event ratesView Large Image Figure ViewerDownload Hi-res image Download (PPT)" @default.
- W3033766051 created "2020-06-12" @default.
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- W3033766051 date "2020-06-01" @default.
- W3033766051 modified "2023-09-26" @default.
- W3033766051 title "Sa2052 SAFETY AND EFFICACY OF ENDOSCOPIC FULL-THICKNESS RESECTION DEVICE (FTRD) IN THE GASTROINTESTINAL TRACT: A SYSTEMATIC REVIEW AND META-ANALYSIS" @default.
- W3033766051 doi "https://doi.org/10.1016/j.gie.2020.03.1848" @default.
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