Meta-Analysis
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Meta-Anal. Jan 12, 2023; 11(1): 38-46
Published online Jan 12, 2023. doi: 10.13105/wjma.v11.i1.38
Cap-assisted endoscopy for esophageal foreign bodies: A meta-analysis
Zahid Ijaz Tarar, Umer Farooq, Matthew L Bechtold, Yezaz A Ghouri
Zahid Ijaz Tarar, Department of Internal Medicine, University of Missouri, Columbia, MO 65212, United States
Umer Farooq, Department of Medicine, Loyola University, Chicago, IL 60153, United States
Matthew L Bechtold, Department of Medicine, University of Missouri - Columbia, Columbia, MO 65212, United States
Yezaz A Ghouri, Department of Internal Medicine, Division of Gastroenterology and Hepatology, University of Missouri, Columbia, MO 65212, United States
Author contributions: Tarar Z and Bechtold ML designed the meta-analysis; Tarar Z, Farooq U, and Bechtold ML acquired the data; Tarar Z, Bechtold ML, and Ghouri YA analyzed and interpreted the data; Tarar Z and Farooq U drafted the manuscript; Bechtold ML and Ghouri YA critically revised the manuscript; and Bechtold ML provided statistical expertise.
Conflict-of-interest statement: All the authors have no conflicts of interest for this manuscript.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Matthew L Bechtold, AGAF, FACG, FASGE, MD, Professor, Department of Medicine, University of Missouri - Columbia, 5 Hospital Drive, Columbia, MO 65212, United States. bechtoldm@health.missouri.edu
Received: October 15, 2022
Peer-review started: October 15, 2022
First decision: October 31, 2022
Revised: November 11, 2022
Accepted: December 21, 2022
Article in press: December 21, 2022
Published online: January 12, 2023
Processing time: 194 Days and 12.9 Hours
Abstract
BACKGROUND

Esophageal foreign bodies are common around the world. Newer approaches, such as cap-assisted endoscopy, have been introduced as an alternative to conventional methods. Therefore, we performed a meta-analysis ono cap-assisted endoscopy versus conventional endoscopy for removal of esophageal foreign bodies.

AIM

To investigated the effectiveness of cap-assisted endoscopy with conventional endoscopy.

METHODS

An extensive literature search was performed (December 2021). For esophageal foreign body removal, cap-assisted endoscopy was compared to conventional endoscopy for procedure time, technical success of the procedure, time of foreign body retrieval, en bloc removal, and adverse event rate using odds ratio and mean difference.

RESULTS

Six studies met the inclusion criteria (n = 1305). Higher odds of technical success (P = 0.002) and en bloc removal (P < 0.01) and lower odds of adverse events (P = 0.02) and foreign body removal time (P < 0.01) were observed with cap-assisted endoscopy as compared to conventional techniques.

CONCLUSION

For esophageal foreign bodies, the technique of cap-assisted endoscopy demonstrated increased en bloc removal and technical success with decreased time and adverse events as compared to conventional techniques.

Keywords: Esophageal foreign body; Food bolus; Endoscopy; Snares; Forceps; Assisted devices; Cap-assisted endoscopy

Core Tip: Esophageal foreign body impaction is very common worldwide. Many techniques have been used to treat these impactions. A newer technique of using a cap on the endoscope to assist the removal of the foreign body has been introduced. Therefore, we performed a meta-analysis. This meta-analysis showed that cap-assisted endoscopy has higher odds of technical success and en bloc removal as well as lower odds of adverse events and reduced procedure time for removal of impacted esophageal foreign bodies as compared to conventional techniques. With this information, cap-assisted endoscopy should be highly considered in removal of esophageal foreign bodies.