PT  - JOURNAL ARTICLE
AU  - Song, Min-Min
AU  - Wang, Feng-Bing
AU  - Yang, Jian-Lin
AU  - Zhang, Hai-Yan
AU  - Wang, Tai-Ping
TI  - Pocket-creation method versus conventional method of endoscopic submucosal dissection for early gastric cancer
AID  - 10.15537/smj.2025.46.5.20250045
DP  - 2025 May 01
TA  - Saudi Medical Journal
PG  - 450--458
VI  - 46
IP  - 5
4099  - http://smj.org.sa/content/46/5/450.short
4100  - http://smj.org.sa/content/46/5/450.full
SO  - Saudi Med J2025 May 01; 46
AB  - Objectives: To compare the efficacy and safety between 2 endoscopic surgical approaches for early gastric cancer: pocket creation method of endoscopic submucosal dissection (PCM-ESD) and conventional ESD (CM-ESD).Methods: A comprehensive literature search was carried out in PubMed, China National Knowledge Infrastructure, and the Cochrane Library from their inception to July 2024 using medical subject headings and free-text terms, which were “pocket-creation method”, “gastric cancer”, “gastric neoplasms”, and “endoscopic submucosal dissection” or “ESD”. Two independent reviewers carried out the search, screened studies, and extracted data.Results: A total of 578 cases were included in our study, which sourced from 2 randomized controlled trials and 5 retrospective cohort studies. Among them, 258 cases were in the intervention group that received PCM-ESD, and 320 cases were in the control group that received CM-ESD. The PCM-ESD demonstrated a significantly faster dissection speed (mean difference=5.57 mm²/min; 95% confidence interval: [4.24-6.91]; p<0.00001) and shorter procedure time compared to CM-ESD. The incidence of intraoperative perforation in the PCM-ESD group was notably lower than that in the CM-ESD group. In terms of complete resection, R0 resection, or delayed bleeding, the 2 groups had no significant differences.Conclusion: For endoscopists, the use of PCM in early gastric cancer seems to be superior to CM-ESD in terms of dissection speed and the procedure time, and got a lower incidence of perforation. Moreover, there was no discernible difference between the 2 groups’ rates of en bloc and R0 resection, and the use of PCM-ESD did not increase the chance of delayed bleeding.PROSPERO No. ID: CRD42024564118