Yang XZ, Yu DL, Wang Z, Gao ZL. Efficacy and safety of over-the-scope-clips in the therapy of acute nonvariceal upper gastrointestinal bleeding: Meta-analysis. World J Clin Cases 2024; 12(21): 4680-4690 [DOI: 10.12998/wjcc.v12.i21.4680]
Corresponding Author of This Article
Zhi Wang, MM, Nurse, Department of Gastroendoscopy, Renmin Hospital, Hubei University of Medicine, No. 39 Chaoyang Middle Road, Shiyan 442000, Hubei Province, China. 16671498503@163.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Meta-Analysis
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (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: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Jul 26, 2024; 12(21): 4680-4690 Published online Jul 26, 2024. doi: 10.12998/wjcc.v12.i21.4680
Efficacy and safety of over-the-scope-clips in the therapy of acute nonvariceal upper gastrointestinal bleeding: Meta-analysis
Xue-Zhu Yang, Dan-Li Yu, Zhi Wang, Zhi-Long Gao
Xue-Zhu Yang, Dan-Li Yu, Zhi Wang, Department of Gastroendoscopy, Renmin Hospital, Hubei University of Medicine, Shiyan 442000, Hubei Province, China
Zhi-Long Gao, Department of Gastrointestinal Medicine III, Renmin Hospital, Hubei University of Medicine, Shiyan 442000, Hubei Province, China
Co-first authors: Xue-Zhu Yang and Dan-Li Yu.
Co-corresponding authors: Zhi Wang and Zhi-Long Gao.
Author contributions: Yang XZ and Yu DL contributed equally to this work as co-first authors; Wang Z and Gao ZL contributed equally to this work as co-corresponding authors; Yang XZ and Yu DL designed this study; Yang XZ, Yu DL, Wang Z and Gao ZL analyzed the data; Yang XZ and Yu DL wrote manuscript; and all authors read and approved the final manuscript.
Conflict-of-interest statement: Dr. Wang has nothing to disclose.
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: Zhi Wang, MM, Nurse, Department of Gastroendoscopy, Renmin Hospital, Hubei University of Medicine, No. 39 Chaoyang Middle Road, Shiyan 442000, Hubei Province, China. 16671498503@163.com
Received: March 4, 2024 Revised: May 10, 2024 Accepted: June 11, 2024 Published online: July 26, 2024 Processing time: 117 Days and 21.7 Hours
Abstract
BACKGROUND
Acute nonvariceal upper gastrointestinal bleeding (ANVUGIB) is a frequent life-threatening acute condition in gastroenterology associated with high morbidity and mortality. Over-the-scope-clip (OTSC) is a new endoscopic hemostasis technique, which is being used in ANVUGIB and is more effective.
AIM
To summarize and analyze the effects of the OTSC in prevention of recurrent bleeding, clinical success rate, procedure time, hospital stay, and adverse events in the treatment of ANVUGIB, to evaluate whether OTSC can replace standard endoscopic therapy as a new generation of treatment for ANVUGIB.
METHODS
The literature related to OTSC and standard therapy for ANVUGIB published before January 2023 was searched in PubMed, Web of Science, EMBASE, Cochrane, Google, and CNKI databases. Changes in recurrent bleeding (7 or 30 days), clinical results (clinical success rate, conversion rate to surgery, mortality), therapy time (procedure time, hospital stay), and adverse events in the OTSC intervention group were summarized and analyzed, and the MD or OR of 95%CI is calculated by Review Manager 5.3.
RESULTS
This meta-analysis involved 11 studies with 1266 patients. Total risk of bias was moderate-to-high. For patients in the OTSC group, 7- and 30-days recurrent bleeding rates, as well as procedure time, hospital stay, and intensive care unit stay, were greatly inhibited. OTSC could significantly improve the clinical success rate of ANVUGIB. OTSC therapy did not cause serious adverse and was effective in reducing patient mortality.
CONCLUSION
OTSC may provide more rapid and sustained hemostasis, and thus, promote recovery and reduce mortality in patients with ANVUGIB. In addition, the safety of OTSC is assured.
Core Tip: Upper gastrointestinal bleeding, especially Acute nonvariceal upper gastrointestinal bleeding (ANVUGIB) is a common life-threatening acute condition with high morbidity and mortality in gastroenterology. With the advancements in medical technology, a new endoscopic hemostatic technique, called the over-the-scope-clip (OTSC), is being used for ANVUGIB treatment. We performed a meta-analysis to study the role of OTSC in ANVUGIB treatment in terms of prevention of rebleeding, clinical success rate, procedure time, hospitalization time, and adverse events. We aim to determine whether OTSC could replace standard endoscopic treatment as a new generation of ANVUGIB treatment.
