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Water-jet vs traditional triangular tip knife in peroral endoscopic myotomy for esophageal dysmotility:A systemic review and metaanalysis

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World Journal of gastrointestinal endoscopy 2022年第10期14卷 608-615页

作者： Yuliya Belopolsky Srinivas R Puli Division of Gastroenterology and Hepatology University of Illinois College of Medicine at PeoriaPeoriaIL 61605United States

BACKGROUND Peroral endoscopic myotomy is an increasingly used less invasive modality to treat esophageal ***,triangular tip knife with integrated water jet function has been introduced to mitigate multiple instrument *** To compare traditional triangular tip knife and water jet knife in terms of procedural success,duration,instrument exchanges,coagulation forceps use,and adverse *** We conducted a systemic review and meta-analysis with two authors independently in electronic databases(PubMed,Embase,and Cochrane Library)from inception through May *** addition,we conducted a relevant search by Reference Citation Analysis(RCA)(https://***).A fixed-effects model was used to calculate weighted mean,odds ratio(OR),and confidence intervals(CI).RESULTS We included 7 studies involving 558 *** knife and water jet knife were similar in odds of procedural success with ratio of 4.78(95%CI=0.22-102.47)and odds of clinical success with ratio of 0.93(95%CI=0.29-2.97),*** jet knife had fewer instrument exchanges compared to triangular knife(2.21,95%CI=1.98-2.45 vs 11.9,95%CI=11.15-12.70)and usage of coagulation forceps(1.75,95%CI=1.52-1.97 vs 2.63,95%CI=2.37-2.89).Adverse events were higher in triangular knife group(OR:2.30,95%CI=1.35-3.95).CONCLUSION Peroral endoscopic myotomy using water jet knife is comparable in terms of pro cedural success to triangular tip *** jet knife also required shorter procedural duration,less instrument exchanges,coagulation devices,and overall adverse events.

关键词： Gastroenterology endoscopy gastrointestinal Esophageal motility disorders Water jet knife Dysmotility

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