Endoscopy 2025; 57(S 02): S421
DOI: 10.1055/s-0045-1806076
Abstracts | ESGE Days 2025
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Over the scope clips after endoscopic removal of duodenal tumors: a systematic review and meta-analysis

A A Awad
1   Faculty of Medicine Al-Azhar University Boy's Branch in Cairo, Cairo, Egypt
2   Medical Research Group of Egypt (MRGE), Cairo, Egypt, Cairo, Egypt
,
O Saeed
3   Faculty of Medicine, Al-Azhar University, Damietta,Egypt, damietta, Egypt
,
A Saeed
3   Faculty of Medicine, Al-Azhar University, Damietta,Egypt, damietta, Egypt
,
A Y Shaban
4   Faculty of Medicine, Kafr El-Shaikh, Egypt
,
M Mahmoud Marey
5   Alexandria Faculty of Medicine, Alexandria, Egypt
,
A M Othman
4   Faculty of Medicine, Kafr El-Shaikh, Egypt
,
MA Aldemerdash
6   Faculty Of Medicine Sohag university, Sohag, Egypt
,
A Aldemerdash
6   Faculty Of Medicine Sohag university, Sohag, Egypt
› Author Affiliations
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    Aims Over-the-scope clips (OTS-clips) are used after endoscopic resections to treat mucosal defects, postoperative anastomotic leakages, and gastrointestinal perforations. Duodenal endoscopic submucosal dissection (ESD) is associated with a high complication rate and adverse events with conventional clip closure. Therefore, we aim to assess the safety and efficacy of OTS-clips compared to conventional clips in patients undergoing ESD.

    Methods Following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, we searched four electronic databases (PubMed, Scopus, Cochrane Library, and Web of Science) to identify eligible studies reported up to November 2024. Using R statistical software (version 2024.04.2 Build 764), we reported outcomes as pooled mean difference (MD), pooled risk ratio (RR), and confidence intervals (CIs).

    Results Twelve studies, with a total population of 700 participants were included. Our analysis of technical success, considering the OTS-clips group showed a pooled proportion of 0.94, 95% CI [0.87, 0.97], and a nonsignificant heterogeneity (I2=0%, P = 0.70). Considering the OTS-clips group, en bloc resection and full-thickness resection proportion were 0.98, 95% CI [0.93, 1.00] and 0.91, 95% CI [0.71, 0.98] respectively. Regarding the adverse events, there were no significant differences between the two groups regarding intra-operative perforation, post-operative bleeding, and post-operative perforation. Considering the OTS-clips group versus the conventional clips group, R0 resection significantly favored the OTS-clips group 1.35, 95% CI [1.06, 1.73] with nonsignificant heterogeneity (I2=0%, P = 0.50). Procedure time and hospital Stay showed no difference between the groups.

    Conclusions These results emphasis the potential beneficial role of OTS-clips and highlight its clinical utility as an adjunctive therapy to ESD in the management of duodenal tumors. Large-scale studies are recommended to delineate the significance of possible important outcomes such as mortality rate and adverse events.


     

    Conflicts of Interest

    Authors do not have any conflict of interest to disclose.

    Publication History

    Article published online:
    27 March 2025

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