Evidence map›Paper›PMID 33825013›Full record

SynthesisSurgical endoscopy2022

Traction-assisted endoscopic submucosal dissection reduces procedure time and risk of serious adverse events: a systematic review and meta-analysis.

Chawin Lopimpisuth, Malorie Simons, Venkata S Akshintala, Klaorat Prasongdee, Julie Nanavati, Saowanee Ngamruengphong

Abstract readMeta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Surgical endoscopy, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
21citing papers in PubMed, 6 pooled it
3.2field-weighted citation impact, top 7% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

21 citing papers in PubMed, 6 syntheses or guidelines pooled it, 32 citations in OpenAlex.

  1. Pooled it
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  6. Pooled it
  7. A Novel Elastic Silicone Ring for Traction in ESD: Initial Experience With the Endo-Silicone Loop Band (With Video).Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society · 2026
    Article
  8. Technical considerations for endoscopic submucosal dissection of a large rectal laterally spreading tumor.VideoGIE : an official video journal of the American Society for Gastrointestinal Endoscopy · 2026
    Article
  9. Review
  10. Article
  11. Review
  12. Review
  13. Multipoint adjustable traction for endoscopic submucosal dissection using a helix tack suturing system: a case series.VideoGIE : an official video journal of the American Society for Gastrointestinal Endoscopy · 2025
    Article
  14. Article
  15. Article
  16. Article
  17. Article
  18. Review
  19. [Efficacy of endoscopic submucosal dissection assisted by metal-clip pocket creation traction for colorectal tumors].Nan fang yi ke da xue xue bao = Journal of Southern Medical University · 2023
    Article
  20. Novel articulating through-the-scope traction device.VideoGIE : an official video journal of the American Society for Gastrointestinal Endoscopy · 2022
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 2 institutions in 2 countries.

Chawin Lopimpisuth *Division of Gastroenterology and Hepatology, Johns Hopkins University, 733 N Broadway, Baltimore, MD, USA.
Malorie Simons *Division of Gastroenterology and Hepatology, Johns Hopkins University, 733 N Broadway, Baltimore, MD, USA. malorie.simons@gmail.com.ORCID http://orcid.org/0000-0001-7552-3883
Venkata S AkshintalaDivision of Gastroenterology and Hepatology, Johns Hopkins University, 733 N Broadway, Baltimore, MD, USA.
Klaorat PrasongdeeFaculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok, Thailand.
Julie NanavatiWelch Medical Library, Johns Hopkins University, Baltimore, MD, USA.
Saowanee NgamruengphongDivision of Gastroenterology and Hepatology, Johns Hopkins University, 733 N Broadway, Baltimore, MD, USA.
Johns Hopkins University · USChulalongkorn University · TH

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND AND

aimsConventional endoscopic submucosal dissection (C-ESD) is a technically demanding procedure with prolonged procedure times and higher risk of adverse events. To overcome the procedural difficulty of ESD, several traction-assisted techniques (T-ESD) have been developed to improve visualization of the submucosa in hopes to facilitate safe and effective dissection. The aim of this study was to conduct a meta-analysis that compares short-term outcomes (30-day) of T-ESD to C-ESD.

methodsClinical studies published up to April 2020 comparing the efficacy and safety of T-ESD and C-ESD were identified using electronic bibliographic searches. Both randomized controlled trials and observational studies were included. Outcomes of interests were procedure time, rates of en bloc and R0 resection, and rates of adverse events. Fixed effect and random effect model were used to calculate pooled mean difference for continuous variables and risk differences (RDs) for categorical variables.

resultsTwenty-three studies with 2574 patients were included in this meta-analysis, with a total of 2582 lesions (1292 T-ESD and 1290 C-ESD). Pooled estimates of T-ESD showed shorter procedure times (weighted mean difference = -20.35 min, 95% CI -27.51 to -13.19, p < 0.001), higher R0 resection rates (RD 0.04, 95% CI 0.01-0.06, p = 0.004) and lower perforation rates (RD -0.03, 95% CI -0.04 to -0.01, p =  < 0.0001). No significant differences were seen in en bloc rates and bleeding risk between the two groups.

conclusionsTraction-assisted ESD results in shorter procedure time, improved R0 resection rates and lower risk of perforation as compared to conventional ESD.

Indexed as

Endoscopic Mucosal ResectionDissectionHumansTractionTreatment OutcomeEndoscopic resectionEndoscopic submucosal dissectionSuperficial gastrointestinal neoplasmsTraction

Identifiers

PMID33825013
OpenAlexW3146169678

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.