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, 戴天阳, 杨晓燕, 等. 外科途径治疗经保守处理无效的食管异物. 中国胸心血管外科临床杂志, 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. 赵刚, 杨龙宝, 董蕾, 等. 透明帽辅助内镜下食管异物治疗术的疗效分析. 中国内镜杂志, 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. 冯颖勋, 翟建欣. 透明帽辅助无痛胃镜下食管异物取出术的疗效评价. 中国实用医刊, 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. 韩娅玲. 透明帽辅助胃镜治疗食管狭窄部尖锐异物的临床价值. 中国社区医师, 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. 刘鸿儒, 吴锋, 尚国印. 电子胃镜加用透明帽对食管异物取出手术的辅助效果分析. 临床和实验医学杂志, 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. 杨艳琼. 探讨透明帽辅助上消化道异物取出术在取出食管异物中的应用. 中国保健营养, 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. 透明帽辅助胃镜异物取出术治疗食管入口异物的疗效观察. 基层医学论坛, 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. 张令. 透明帽辅助下胃镜食道异物取出术的临床效果及安全性观察. 中国初级卫生保健, 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, 高谢琼. 透明帽辅助内镜下食管异物取出术与传统内镜下异物取出术的效果比较. 临床医学研究与实践, 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. 屈伟明, 陈维顺, 郭有玲, 等. 透明帽辅助胃镜治疗食管狭窄部尖锐异物疗效分析. 中国医师杂志, 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. 透明帽辅助下取食管异物的优点. 医学信息, 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. 孙敏. 普通电子胃镜与透明帽辅助电子胃镜对食管异物取出情况的影响. 临床医药文献电子杂志, 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, 龚伟, 高俊泽, 等. 电子胃镜加用不同型号透明帽在食管异物取出术的效果研究. 现代消化及介入诊疗, 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. 张坤峰, 雷平光, 崔毅. 内镜下透明帽辅助处理食管上段异物的前瞻性研究. 山西医药杂志, 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. 李韶华, 谢华红, 柯小茹, 等. 普通电子胃镜与透明帽辅助电子胃镜对食管异物取出情况的影响. 解放军医药杂志, 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.
25. 张妍, 韩真, 袁鹤鸣. 透明帽辅助胃镜食道异物取出术的临床应用评价. 皖南医学院学报, 2017, 36(3): 234-236.Zhang Y, Han Z, Yuan HM. Evaluation of the clinical application of transparent cap-assisted endoscopic esophageal foreign body removal. J Wannan Med Coll, 2017, 36(3): 234-236.
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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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