Efficacy and safety of endoscopic transcecal appendectomy: a systematic review and meta-analysis

Source: PubMed Central Open Access, NCBI / U.S. National Library of Medicine

Background Appendiceal orifice polyps are rare with prevalence of 0.08%. Surgical approach is the standard approach. Endoscopic transcecal appendectomy (ETA) has several potential advantages when compared to surgery and an alternative to non-surgical candidates. In this study, we review the efficacy and safety of ETA for the management of appendiceal lesions Methods A systematic literature search was conducted across MEDLINE/PubMed, Embase, Scopus, Web of Science, and Cochrane databases. Three studies were included. The primary outcome was the efficacy of ETA in achieving technical success andresection. Risk of bias was assessed using Joanna Briggs Institute (JBI) Critical Appraisal Checklist for Case Series. A single arm meta-analysis was performed. Results A total of three studies were included. A total of 45 patients were included. The mean age was 61.8±14.22 years. Tubular adenoma was the most common pathology, with 12 adenomas. The technical success rate was 100% [95% confidence interval (CI): 92–100%]. Theresection had a success rate of 97% (95% CI: 90–100%). No bleeding events were observed with rates of 0.0% (95% CI: 0.00–0.05). Perforation was observed in 2 of 45 patients with rates of 3.0% (95% CI: 0.0–9.0%). Conclusions This meta-analysis shows that ETA is a promising, minimally invasive technique for appendiceal polyps. It demonstrated high technical success rates in the included series. It also showed promising safety profile with minimal complications reported.