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Background <p>Despite the global use of endoscopic submucosal dissection (ESD) as a&#xa0;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.</p> Patients and methods <p>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.</p> Results <p>We conducted a&#xa0;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&#xa0;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: [0–0.04]), respectively.</p> Conclusion <p>Endoscopic hand suturing demonstrates feasible suturing times and a&#xa0;favorable safety profile, supporting its potential role as a&#xa0;reliable adjunctive technique following gastric ESD.</p>

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Efficacy and safety of hand suturing technique application in the endoscopic treatment of gastrointestinal tract tumors: a systematic review and meta-analysis

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年7月28日

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  • Mohamed Mahmoud Marey,
  • Abdelaziz A. Awad,
  • Amany Mahmoud Genidy,
  • Aliaa Bahaa Abdelaziz,
  • Menna M. Aboelkhier,
  • Mazen Negmeldin Aly Yassin,
  • Mohamed A. Aldemerdash,
  • Ahmed Aldemerdash,
  • Mohamed Eldesouki,
  • Abdelrahman Shata,
  • Mohamed Hamed,
  • Ahmed R. A. Abou-Shanab,
  • Ahmed Yasser Shaban,
  • Mohamed Abouzid

摘要

Background

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.

Patients and methods

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.

Results

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: [0–0.04]), respectively.

Conclusion

Endoscopic hand suturing demonstrates feasible suturing times and a favorable safety profile, supporting its potential role as a reliable adjunctive technique following gastric ESD.