Efficacy and safety of cap-assisted endoscopy in the treatment of esophageal foreign bodies: A systematic review and meta-analysis_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

MIN Weirun ^1,2 , HONG Ziqiang ² , CUI Baiqiang ² , JIN Dacheng ² ,  DONG Xinchun ² ,  GOU Yunjiu ²

1. First Clinical Medical School, Gansu University of Chinese Medicine, Lanzhou, 730000, P. R. China;
2. First Department of Thoracic Surgery, Gansu Provincial Hospital, Lanzhou, 730000, P. R. China;

Corresponding?author：

DONG Xinchun, Email: 3050319523@qq.com; GOU Yunjiu, Email: gouyunjiu@163.com

Keywords：

Esophageal foreign body; cap-assisted endoscopy; endoscopic therapy; systematic review/meta-analysis

DOI：

10.7507/1007-4848.202301016

Video：

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Objective To systematically review the efficacy and safety of cap-assisted endoscopy in the treatment of esophageal foreign bodies. Methods PubMed, Web of Science, The Cochrane Library, EMbase, CNKI and Wanfang databases were searched by computer for relevant literatures on cap-assisted endoscopy and traditional endoscopy for esophageal foreign bodies from inception to November 2022. The quality assessment of the literature was conducted using the Newcastle-Ottawa Scale (NOS). Meta-analysis was performed using RevMan 5.4.1. Results Finally, 27 studies were collected, including 17 randomized controlled trials, 2 cohort studies and 8 case-control studies, with a total of 3 619 patients. NOS scores of all studies were ≥7 points. Meta-analysis results showed that compared with traditional endoscopic treatment, the success rate of removing esophageal foreign bodies in the cap-assisted endoscopy group was higher (OR=14.43, 95%CI 10.64 to 19.55, P<0.000 1), postoperative complications were fewer (OR=0.30, 95%CI 0.23 to 0.38, P<0.000 1), patients' tolerance was better (OR=4.07, 95%CI 2.95 to 5.60, P<0.000 1), intraoperative visual field clarity was better (OR=12.00, 95%CI 7.29 to 19.76, P<0.000 1) and operative time was shorter (SMD=?1.83, 95%CI ?2.31 to ?1.34, P<0.000 1). Conclusion Cap-assisted endoscopy for esophageal foreign bodies is an effective and safe method, worthy of further promotion and application in clinical practice.

Citation： MIN Weirun, HONG Ziqiang, CUI Baiqiang, JIN Dacheng, DONG Xinchun, GOU Yunjiu. Efficacy and safety of cap-assisted endoscopy in the treatment of esophageal foreign bodies: A systematic review and meta-analysis. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2024, 31(12): 1846-1854. doi: 10.7507/1007-4848.202301016 Copy

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1. ASGE Standards of Practice Committee, Ikenberry SO, Jue TL, et al. Management of ingested foreign bodies and food impactions. Gastrointest Endosc, 2011, 73(6): 1085-1091.
2. Monnier P. Acute food bolus impaction in the esophagus. Eur Arch Otorhinolaryngol, 2005, 262(7): 523.
3. Lacy PD, Donnelly MJ, McGrath JP, et al. Acute food bolus impaction: Aetiology and management. J Laryngol Otol, 1997, 111(12): 1158-1161.
4. Dray X, Cattan P. Foreign bodies and caustic lesions. Best Pract Res Clin Gastroenterol, 2013, 27(5): 679-689.
5. 王超, 戴天陽, 楊曉燕, 等. 外科途徑治療經保守處理無效的食管異物. 中國胸心血管外科臨床雜志, 2018, 25(6): 539-542.Wang C, Dai TY, Yang XY, et al. Surgical approach for oesophageal foreign bodies without conservative management. Chin J Clin Thorac Cardiovasc Surg, 2018, 25(6): 539-542.
6. Birk M, Bauerfeind P, Deprez PH, et al. Removal of foreign bodies in the upper gastrointestinal tract in adults: European Society of Gastrointestinal Endoscopy (ESGE) clinical guideline. Endoscopy, 2016, 48(5): 489-496.
7. 趙剛, 楊龍寶, 董蕾, 等. 透明帽輔助內鏡下食管異物治療術的療效分析. 中國內鏡雜志, 2017, 23(7): 26-29.Zhao G, Yang LB, Dong L, et al. Effect of transparent cap-assisted endoscopic esophageal foreign body removal. China J Endosc, 2017, 23(7): 26-29.
8. 馮穎勛, 翟建欣. 透明帽輔助無痛胃鏡下食管異物取出術的療效評價. 中國實用醫刊, 2022, 49(7): 51-54.Feng YX, Zhai JX. Evaluation of the efficacy of transparent cap assisted esophageal foreign body removal. China Prac Med J, 2022, 49(7): 51-54.
9. 韓婭玲. 透明帽輔助胃鏡治療食管狹窄部尖銳異物的臨床價值. 中國社區醫師, 2021, 37(17): 21-22.Han YL. Clinical value of transparent cap-assisted gastroscopy in the treatment of sharp foreign bodies in esophageal stenosis. Chin Comm Phys, 2021, 37(17): 21-22.
10. 劉鴻儒, 吳鋒, 尚國印. 電子胃鏡加用透明帽對食管異物取出手術的輔助效果分析. 臨床和實驗醫學雜志, 2021, 20(1): 96-100.Liu HR, Wu F, Shang GY. Analysis of the auxiliary effect of electronic gastroscope with transparent cap on esophageal foreign body removal surgery. J Clin Exp Med, 2021, 20(1): 96-100.
11. 楊艷瓊. 探討透明帽輔助上消化道異物取出術在取出食管異物中的應用. 中國保健營養, 2020, 30(14): 349.Yang YQ. The application of transparent cap assisted upper gastrointestinal foreign body removal in esophageal foreign body removal was discussed. China Health Care Nutr, 2020, 30(14): 349.
12. 蒲蕙. 透明帽輔助胃鏡異物取出術治療食管入口異物的療效觀察. 基層醫學論壇, 2020, 24(28): 4049-4050.Pu H. Efficacy observation of transparent cap-assisted endoscopic foreign body removal in the treatment of esophageal inlet foreign body. Forum Primary Med, 2020, 24(28): 4049-4050.
13. 張令. 透明帽輔助下胃鏡食道異物取出術的臨床效果及安全性觀察. 中國初級衛生保健, 2020, 34(6): 109-111.Zhang L. Clinical effect and safety observation of gastroscopic esophageal foreign body removal under transparent cap assistance. Prim Health Care China, 2020, 34(6): 109-111.
14. 柴建中, 高謝瓊. 透明帽輔助內鏡下食管異物取出術與傳統內鏡下異物取出術的效果比較. 臨床醫學研究與實踐, 2019, 4(2): 51-52.Cai JZ, Gao XQ. Comparison of transparent cap-assisted endoscopic esophageal foreign body removal with traditional endoscopic foreign body removal. Clin Med Res Pract, 2019, 4(2): 51-52.
15. 屈偉明, 陳維順, 郭有玲, 等. 透明帽輔助胃鏡治療食管狹窄部尖銳異物療效分析. 中國醫師雜志, 2019, 21(2): 284-286.Qu WM, Chen WS, Guo YL, et al. Analysis of the efficacy of transparent cap-assisted gastroscopy in the treatment of esophageal stenosis. Chin J Phys, 2019, 21(2): 284-286.
16. 洪谷俞. 透明帽輔助下取食管異物的優點. 醫學信息, 2019, 32(z1): 125.Hong GY. Advantages of taking a foreign body in the food tube assisted by the transparent cap. Med Inf, 2019, 32(z1): 125.
17. 孫敏. 普通電子胃鏡與透明帽輔助電子胃鏡對食管異物取出情況的影響. 臨床醫藥文獻電子雜志, 2019, 6(47): 59-60.Sun M. Effect of common electronic gastroscope and transparent cap-assisted electronic gastroscope on esophageal foreign body removal. Electr J Clin Med Lit, 2019, 6(47): 59-60.
18. 李佩武, 龔偉, 高俊澤, 等. 電子胃鏡加用不同型號透明帽在食管異物取出術的效果研究. 現代消化及介入診療, 2019, 24(6): 638-642.Li PW, Gong W, Gao JZ, et al. Study on the effect of electronic gastroscope with different models of transparent cap in esophagus. Mod Interv Diagn Treat Gastroenterol, 2019, 24(6): 638-642.
19. Fang R, Cao B, Zhang Q, et al. The role of a transparent cap in the endoscopic removal of foreign bodies in the esophagus: A propensity score-matched analysis. J Dig Dis, 2020, 21(1): 20-28.
20. Wang Y, Chen W. Role of endoscopic transparent cap in managing pediatric foreign bodies in the entrance of the esophagus in a waking state. J Thorac Dis, 2019, 11(10): 4357-4363.
21. Wahba M, Habib G, Mazny AE, et al. Cap-assisted technique versus conventional methods for esophageal food bolus extraction: A comparative study. Clin Endosc, 2019, 52(5): 458-463.
22. Ooi M, Young EJ, Nguyen NQ. Effectiveness of a cap-assisted device in the endoscopic removal of food bolus obstruction from the esophagus. Gastrointest Endosc, 2018, 87(5): 1198-1203.
23. 張坤峰, 雷平光, 崔毅. 內鏡下透明帽輔助處理食管上段異物的前瞻性研究. 山西醫藥雜志, 2017, 46(12): 1412-1414.Zhang KF, Lei PG, Cui Y. Prospective study of endoscopic treatment of upper esophageal foreign body. Shanxi Med J, 2017, 46(12): 1412-1414.
24. 李韶華, 謝華紅, 柯小茹, 等. 普通電子胃鏡與透明帽輔助電子胃鏡對食管異物取出情況的影響. 解放軍醫藥雜志, 2017, 29(9): 96-98.Li SH, Xie HH, Ke XR, et al. Effect of common electronic gastroscope and transparent cap-assisted electronic gastroscope on esophageal foreign body removal. Med Pharm J Chin PLA, 2017, 29(9): 96-98.
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Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Efficacy and safety of cap-assisted endoscopy in the treatment of esophageal foreign bodies: A systematic review and meta-analysis

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