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ADSC-sheet Transplantation to Prevent Stricture after Extended Esophageal Endoscopic Submucosal Dissection
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Comparing outcomes for endoscopic submucosal dissection between Eastern and Western countries: A systematic review
Dane Christina Daoud1, Nicolas Suter2, Madeleine Durand3
1Department of Medicine, Division of Gastroenterology, Centre Hospitalier de l'Université de Montréal (CHUM) and Centre de Recherche du Centre hospitalier de l'Université de Montréal (CRCHUM), Montreal, Quebec H2X 0A9, Canada.
World Journal of Gastroenterology
|June 23, 2018
Summary
Endoscopic submucosal dissection (ESD) shows better outcomes in Eastern countries compared to Western countries, particularly in curative resection rates. Western countries experienced higher complication rates and longer procedure times for ESD.
Area of Science:
- Gastroenterology
- Surgical Oncology
- Endoscopic Procedures
Background:
- Endoscopic submucosal dissection (ESD) is a minimally invasive technique for gastrointestinal lesion resection.
- Significant regional variations in ESD outcomes may exist, necessitating comparative analysis.
Purpose of the Study:
- To compare the efficacy and safety of endoscopic submucosal dissection (ESD) between Eastern and Western countries.
- To identify factors contributing to outcome disparities in ESD procedures.
Main Methods:
- A systematic review and meta-analysis of studies published between 1990 and February 2016.
- Inclusion of data from PubMed, MEDLINE, Web of Science, CINAHL, and EBM reviews.
- Primary outcome: curative, en bloc, and R0 resection rates; Secondary outcomes: complications, recurrence, and procedure time.
Main Results:
- Analysis of 238 publications involving 84,318 patients and 89,512 resected lesions.
- Eastern countries demonstrated significantly higher pooled rates for curative (82% vs. 71%), en bloc (95% vs. 85%), and R0 resections (89% vs. 74%) compared to Western countries.
- Western countries had a higher incidence of perforation requiring surgery (0.53% vs. 0.01%) and longer procedure times (110 min vs. 77 min).
Conclusions:
- Eastern countries exhibit superior outcomes in endoscopic submucosal dissection (ESD) compared to Western countries.
- Regional expertise and localized outcomes are crucial considerations for optimizing ESD treatment decisions.
- Further investigation into the reasons for these disparities is warranted.
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