SynthesisAnaesthesiology intensive therapy2023
Comparing general anaesthesia versus sedation for endoscopic submucosal dissection: results from a systematic review and meta-analysis.
Synthesis in Anaesthesiology intensive therapy, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
What it found
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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.
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.
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Who cites it
5 citing papers in PubMed, 5 citations in OpenAlex.
- Sedation in Gastrointestinal Endoscopy: From Drug-Centered Protocols to Personalized, Technology-Supported Pathways: A Narrative Review.Journal of clinical medicine · 2026Review
- Comparison of the Efficacy and Safety of General Anesthesia and Sedation Management for Esophageal Endoscopic Submucosal Dissection: A Retrospective Study.JMA journal · 2026Article
- Characteristics of cases for which esophageal endoscopic submucosal dissection under general anesthesia is recommended.Esophagus : official journal of the Japan Esophageal Society · 2025Article
- Spinal anesthesia for endoscopic submucosal dissection of large rectosigmoid lesions: Feasibility study.Endoscopy international open · 2024Article
- Article
Corrections and comments
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Authors and funding
2 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Endoscopic submucosal dissection (ESD) is an advanced endoscopic procedure for management of gastrointestinal tumours. ESD is usually performed under sedation. However, the use of general anaesthesia (GA) has been hypothesised to improve ESD outcomes. We performed a systematic review and meta-analysis to compare GA against sedation in ESD. A systematic literature search was performed on Cochrane Library, EMBASE and MEDLINE using the terms "General Anaesthesia", "Sedation" and "Endoscopic submucosal dissection". Original articles comparing GA versus sedation in ESD were included. The risk of bias and level of evidence were assessed by validated methods. This review is registered in PROSPERO (CRD42021275813). 176 articles were found in the initial literature search, and 7 articles (comprising 518 patients receiving GA and 495 receiving sedation) were included. Compared with sedation, GA was associated with higher en-bloc resection rates in oesophageal ESD (RR 1.05; 95% CI: 1.00-1.10; I 2 = 65%; P = 0.05). GA patients also trended towards lower rates of gastrointestinal perforation in all ESD procedures (RR 0.62; 95% CI: 0.21-1.82; I 2 = 52%; P = 0.06). Rates of intra- procedural desaturation and post-procedural aspiration pneumonia were lower in GA patients than in patients under sedation. The included studies had a moderate to high risk of bias, and the overall level of evidence was low. GA appears safe and feasible for ESD, yet high-quality trials will be required before GA can be regularly implemented for ESD.
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Registered trials
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.