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Review
. 2023 Nov 9;11(11):E1020-E1025.
doi: 10.1055/a-2185-6192. eCollection 2023 Nov.

Cold snare resection for non-ampullary sporadic duodenal adenomas: systematic review and meta-analysis

Mihai Ciocirlan  1 , Diana Lavinia Opri  1 , Dana Maria Bilous  1 , Daniel-Corneliu Leucuta  2 , Elena Tianu  3 , Catalina Vladut  1
Affiliations
Review

Cold snare resection for non-ampullary sporadic duodenal adenomas: systematic review and meta-analysis

Mihai Ciocirlan et al. Endosc Int Open. .

Abstract

Background and study aims The role of cold snare polypectomy (CSP) in curative resection of non-ampullary sporadic duodenal adenomas (NASDA) is debated. We conducted a systematic review and meta-analysis to investigate the efficacy and safety of CSP for NASDA. Patients and methods In this systematic review and meta-analysis, we identified published series of patients with CSP for NASDA by searching PubMed and Google Scholar, which resulted in six papers (205 lesions). The main outcome was the rate of local remission after repeated CSP, the secondary outcomes were rates of local remission at first control and rates for delayed bleeding and immediate perforations. We computed the weighted summary proportions under the fixed and random effects model. Results The pooled proportion of local remission after repeated CSP was 88% (95% confidence interval [CI] 57%-100%). The pooled proportion of local remission at first control was 81% (95% CI 55%-98%), the pooled proportion of delayed bleeding was 1% (95% CI 0%-4%) and the pooled proportion of immediate perforation was 0% (95% CI 0%-2%). Conclusions Our meta-analysis suggests that CSP should be considered as the first-line therapy for NASDA.

Keywords: Endoscopy Small Bowel; Endoscopy Upper GI Tract; Neoplasia; Small intestinal bleeding.

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Conflict of interest statement

Conflict of Interest The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Local remission after repeated CSP. Forest plot, five studies.
Fig. 2
Fig. 2
Local remission at first control. Forest plot, five studies.
Fig. 3
Fig. 3
Delayed bleeding rate. Forest plot, six studies.
Fig. 4
Fig. 4
Perforation rate. Forest plot, six studies.
See this image and copyright information in PMC

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