Authors
Ashesh Das, Arpitha Sirichandana Baggu, Param Darpan Sheth, Nihal Reddy Bandi, Chandana Priya Digumurthy, Urvashi Bharia, Shah Kavya Hiteshkumar, Krishna Sai Kiran Sakalabaktula, Shankar Biswas, Riyakumari Patel, Meenakshi Reddy Yathindra, Venkata Dileep Kumar Veldi
Published in
Clinical endoscopy. Sep 22, 2026. Epub Sep 22, 2026.
Abstract
Gastrointestinal (GI) cancers accounted for 3.24 million deaths worldwide in 2022. Endoscopic submucosal dissection (ESD) enables en bloc resection of early neoplasms but is time-intensive and technically challenging. Hybrid ESD (H-ESD), which combines dissection with snare polypectomy, may improve efficiency while maintaining efficacy.This Bayesian meta-analysis of randomized controlled trials (RCTs) compares the safety and efficacy of H-ESD with conventional ESD (C-ESD).
We searched the PubMed, Embase, Cochrane, Scopus databases for RCTs comparing hybrid and C-ESD for superficial GI neoplasms. Bayesian modeling in Just Another Gibbs Sampler used normal-normal hierarchies for procedure time and logRR for binary outcomes with weakly informative priors. Frequentist analyses were performed using Der-Simonian-Laird τ². Heterogeneity was assessed using I²/τ².
H-ESD showed comparable en bloc (RR, 0.97; 95% [CrI], 0.92-1.03; I²=22.8%) and R0 resection rates (RR, 0.97; 95% CrI, 0.90-1.04; I²=0%). Procedure time decreased significantly with H-ESD (MD, -18.05; 95% CrI, -27.77 to -8.33 minutes; I²=66.5%). Adverse events (RR, 1.08; 95% CrI, 0.44-2.63) and perforations (RR, 1.05; 95% CrI, 0.34-3.19) were similar between the two procedures.
H-ESD matches C-ESD in curative resection while reducing the procedure time, offering a safer and more efficient alternative. Larger RCTs are needed to confirm the long-term benefits.
PMID:
42770231
Bibliographic data and abstract were imported from PubMed on 22 Sep 2026.
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