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
Neoplasia - Endoscopy Small Bowel - Small intestinal bleeding - Endoscopy Upper GI
Tract
