Meta-Analysis of Appendicitis Risk With Endoscopic Full-Thickness Resection of Appendiceal Orifice Lesions
Douglas K. Rex, MD, MASGE, reviewing Obri M, et al. Endosc Int Open 2023 Jul 17.
There is agreement that endoscopic full-thickness resection (EFTR) is a great procedure for lesions extending into the appendiceal orifice (AO) when there has been a previous appendectomy. Absent of prior appendectomy, patients undergoing EFTR of lesions at the AO have a risk of developing appendicitis.
This systematic review and meta-analysis identified 14 relevant studies of EFTR of AO lesions using a full-thickness resection device and evaluated patients for appendicitis risk after the procedure. Among 203 patients with no prior appendectomy, the overall rate of appendicitis after EFTR was 15%, with a 61% rate of patients requiring appendectomy (overall, the need for surgical intervention for appendicitis after EFTR was 11%).
Technical success was 92% in complete resection and 98% with histologic full-thickness resection. Histologic R0 resection was achieved in 72% of patients.
Note to readers: At the time we reviewed this paper, its publisher noted that it was not in final form and that subsequent changes might be made.
Obri M, Ichkhanian Y, Brown P, et al. Full thickness resection device for the management of lesions involving the appendiceal orifice: systematic review and meta-analysis. Endosc Int Open 2023 Jul 17. (Epub ahead of print) (https://doi.org/10.1055/a-2131-4891)