Efficacy and safety of hand suturing technique application in the endoscopic treatment of gastrointestinal tract tumors: a systematic review and meta-analysis
Abstract
Despite the global use of endoscopic submucosal dissection (ESD) as a widely accepted approach for gastrointestinal cancer, there are many associated postoperative complications, including perforation, stenosis, bleeding, pneumonia, and others. We conducted this meta-analysis to evaluate the efficacy and safety of endoscopic hand suturing (EHS) for gastrointestinal cancer patients who underwent gastric ESD. We included studies with patients undergoing EHS after ESD. We searched indexed databases (PubMed, Scopus, Web of Science, CENTRAL, MEDLINE, Embase) until November 2024. We excluded case reports, case series, and conference abstracts. Continuous data were pooled as raw means, while dichotomous data were pooled as proportions, with 95% confidence intervals (CIs) for both. We conducted a comprehensive literature search of electronic databases, retrieving 2108 records. After thorough screening, nine studies involving 245 patients met the PICO criteria. The mean pooled suturing time to close the mucosal defect during EHS was 42.16 min (95% CI [25.99–58.33]), while the time to complete the procedure was 43 min (95% CI: [23.59–62.41]). The pooled analysis yielded a 95% complete closure rate (95% CI: [0.90–0.97]), which was not sustained in only 1% of cases (95% CI: [0–0.07]). For intraoperative complications, the rates of bleeding and perforation were both 0% (95% CI: [0–1.00], [95% CI: 0–0.03]), while the postoperative rates were 3% (95% CI: [0.02–0.07]) and 1% (95% CI:…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 245 participants or records.
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