PMID- 37777353
OWN - NLM
STAT- MEDLINE
DCOM- 20240325
LR  - 20240325
IS  - 1878-3562 (Electronic)
IS  - 1590-8658 (Linking)
VI  - 56
IP  - 4
DP  - 2024 Apr
TI  - Cold-snare endoscopic resection of non-ampullary duodenal adenomas: Systematic 
      review and pooled-analysis.
PG  - 656-662
LID - S1590-8658(23)00956-8 [pii]
LID - 10.1016/j.dld.2023.09.013 [doi]
AB  - BACKGROUND: Mirroring the experience with colonic resections, cold snare-based 
      techniques have been recently proposed for non-ampullary duodenal lesions to 
      reduce the risk of adverse events (AEs). As the duodenal wall is thinner and more 
      vascularized than in the colon, electrocautery-related AEs are relevant issues in 
      this setting. AIMS: We performed a systematic review with pooled-analysis to 
      evaluate the efficacy and safety of this technique. METHODS: Electronic databases 
      (Medline, Scopus, EMBASE) were searched up to January 2023. Full articles 
      including patients with duodenal lesions resected by cold-snare technique were 
      eligible. The adverse events (i.e., bleeding, perforation, stricture), complete 
      resection, and recurrence rates were pooled using a random model. RESULTS: Eleven 
      studies were eligible, providing data on 3137 lesions removed from 233 patients. 
      The overall AE rate for cold snaring was 0.25% (95% CI, 0.19%-0.69%). Among the 
      three studies comparing cold- and hot-snare approaches, procedure-related 
      bleeding rate was significantly lower with cold approach (OR 1.21, 0.51-2.85; p = 
      0.66). The complete resection rate was 99.40% (95% CI, 98.60%-100%), with a 
      residual/recurrence rate of 12.95% (95% CI, 4.75%-21.16%). On univariate 
      meta-regression, lesion size significantly affected both the adverse events and 
      recurrence risk. CONCLUSION: Cold-snare resection appears effective and extremely 
      safe for resecting non-ampullary duodenal lesions.
CI  - Copyright (c) 2023. Published by Elsevier Ltd.
FAU - Spadaccini, Marco
AU  - Spadaccini M
AD  - Humanitas University, Department of Biomedical Sciences, 20072 Pieve Emanuele, 
      Italy; Humanitas Clinical and Research Center -IRCCS-, Endoscopy Unit, 20089 
      Rozzano, Italy. Electronic address: marco.spadaccini@humanitas.it.
FAU - Alfarone, Ludovico
AU  - Alfarone L
AD  - Humanitas University, Department of Biomedical Sciences, 20072 Pieve Emanuele, 
      Italy; Humanitas Clinical and Research Center -IRCCS-, Endoscopy Unit, 20089 
      Rozzano, Italy.
FAU - Facciorusso, Antonio
AU  - Facciorusso A
AD  - University of Foggia, Department of Medical Sciences, Section of 
      Gastroenterology, 71122 Foggia, Italy.
FAU - Gkolfakis, Paraskevas
AU  - Gkolfakis P
AD  - Erasme Hospital, Universite Libre de Bruxelles (ULB), Department of 
      Gastroenterology, Hepatopancreatology, and Digestive Oncology, 1070 CUB Brussels, 
      Belgium.
FAU - Thoguluva Chandrasekar, Viveksandeep
AU  - Thoguluva Chandrasekar V
AD  - Augusta University Medical Center, Department of Gastroenterology and Hepatology, 
      30912 Augusta, GA, USA.
FAU - Fugazza, Alessandro
AU  - Fugazza A
AD  - Humanitas Clinical and Research Center -IRCCS-, Endoscopy Unit, 20089 Rozzano, 
      Italy.
FAU - Colombo, Matteo
AU  - Colombo M
AD  - Humanitas Clinical and Research Center -IRCCS-, Endoscopy Unit, 20089 Rozzano, 
      Italy.
FAU - Capogreco, Antonio
AU  - Capogreco A
AD  - Humanitas Clinical and Research Center -IRCCS-, Endoscopy Unit, 20089 Rozzano, 
      Italy.
FAU - Massimi, Davide
AU  - Massimi D
AD  - Humanitas Clinical and Research Center -IRCCS-, Endoscopy Unit, 20089 Rozzano, 
      Italy.
FAU - Carrara, Silvia
AU  - Carrara S
AD  - Humanitas Clinical and Research Center -IRCCS-, Endoscopy Unit, 20089 Rozzano, 
      Italy.
FAU - Alkandari, Asma
AU  - Alkandari A
AD  - Al Jahra Hospital, Department of Gastroenterology, Kuwait City 32591, Al Jahra, 
      Kuwait.
FAU - Bhandari, Pradeep
AU  - Bhandari P
AD  - Queen Alexandra Hospital, Department of Gastroenterology, PO6 3LY Portsmouth, UK.
FAU - Maselli, Roberta
AU  - Maselli R
AD  - Humanitas University, Department of Biomedical Sciences, 20072 Pieve Emanuele, 
      Italy; Humanitas Clinical and Research Center -IRCCS-, Endoscopy Unit, 20089 
      Rozzano, Italy.
FAU - Hassan, Cesare
AU  - Hassan C
AD  - Humanitas University, Department of Biomedical Sciences, 20072 Pieve Emanuele, 
      Italy; Humanitas Clinical and Research Center -IRCCS-, Endoscopy Unit, 20089 
      Rozzano, Italy.
FAU - Repici, Alessandro
AU  - Repici A
AD  - Humanitas University, Department of Biomedical Sciences, 20072 Pieve Emanuele, 
      Italy; Humanitas Clinical and Research Center -IRCCS-, Endoscopy Unit, 20089 
      Rozzano, Italy.
LA  - eng
PT  - Journal Article
PT  - Systematic Review
DEP - 20230928
PL  - Netherlands
TA  - Dig Liver Dis
JT  - Digestive and liver disease : official journal of the Italian Society of 
      Gastroenterology and the Italian Association for the Study of the Liver
JID - 100958385
SB  - IM
MH  - Humans
MH  - *Colonic Polyps/pathology
MH  - Colonoscopy/methods
MH  - *Adenoma/surgery/pathology
MH  - Duodenum/surgery/pathology
MH  - *Endoscopic Mucosal Resection/adverse effects/methods
MH  - Treatment Outcome
OTO - NOTNLM
OT  - Foregut
OT  - Prevention
OT  - Safety
EDAT- 2023/10/01 04:44
MHDA- 2024/03/25 06:43
CRDT- 2023/09/30 21:53
PHST- 2023/06/18 00:00 [received]
PHST- 2023/08/19 00:00 [revised]
PHST- 2023/09/10 00:00 [accepted]
PHST- 2024/03/25 06:43 [medline]
PHST- 2023/10/01 04:44 [pubmed]
PHST- 2023/09/30 21:53 [entrez]
AID - S1590-8658(23)00956-8 [pii]
AID - 10.1016/j.dld.2023.09.013 [doi]
PST - ppublish
SO  - Dig Liver Dis. 2024 Apr;56(4):656-662. doi: 10.1016/j.dld.2023.09.013. Epub 2023 
      Sep 28.