Submucosal Tunneling Endoscopic Resection Versus Endoscopic Submucosal Dissection for Esophageal Submucosal Tumors: A Meta-Analysis
摘要
Submucosal tunneling endoscopic resection (STER) has emerged as a novel endoscopic technique for the treatment of esophageal submucosal tumors (SMTs). This meta-analysis aimed to compare the efficacy and safety of STER with endoscopic submucosal dissection (ESD) for managing esophageal SMTs.
MethodsA literature search was conducted in PubMed, Embase, and the Cochrane Library through March 11, 2025, to identify comparative studies of STER and ESD. Primary outcomes included complete resection (CR) rate, en bloc resection (ER) rate, length of hospital stay (LOS), and operation time. Secondary outcomes were complication rates and tumor recurrence. Risk of bias and publication bias were assessed for all primary outcomes.
ResultsSix comparative studies were included. There were no significant differences between STER and ESD in terms of CR rate (Risk Ratio [RR] 1.02; 95% Confidence Interval [CI] 0.91 to 1.14; I2 = 58%), ER rate (RR 1.01; 95% CI 0.89 to 1.14; I2 = 67%), or operation time (Mean Difference [MD] 6.12; 95% CI − 8.95 to 21.19; I2 = 97%). However, LOS was significantly shorter in the STER group compared to the ESD group (MD − 2.86; 95% CI − 3.38 to − 2.34; I2 = 61%). Both techniques were associated with a low incidence of complications and tumor recurrence. No significant publication bias was detected for all primary outcomes.
ConclusionBoth STER and ESD are effective and safe techniques for the resection of esophageal SMTs. However, STER is associated with a significantly shorter hospital stay.