Hybrid versus conventional endoscopic submucosal dissection for treatment of gastric lesions: a comparative systematic review and meta-analysis.

Background and Aims: Hybrid endoscopic submucosal dissection (ESD) may overcome the complexity of conventional ESD associated with gastric lesions. The aim of this study was to perform a systematic review and meta-analysis to compare the efficacy and safety of hybrid versus conventional ESD for the treatment of gastric lesions. Methods: Individualized search strategies were developed in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses and Meta-Analysis of Observational Studies in Epidemiology guidelines. Pooled proportions were calculated with rates estimated using random-effects models. Measured outcomes included en-bloc resection, procedure-associated adverse events, and procedure duration. Heterogeneity was assessed with the Results: Of 5 included comparator studies (hybrid ESD, 184 patients; conventional ESD, 289 patients), 1 was a randomized trial and 4 were retrospective observational studies. Mean patient age was 68.89 ± 4.75 years, and the average lesion size was 17.81 ± 5.58 mm. Hybrid ESD patients were older ( Conclusions: Although hybrid ESD for gastric lesions was associated with significantly shorter procedure times compared with conventional ESD, hybrid ESD was associated with lower rates of en-bloc resection and similar adverse events.