al obaidi, hasan

Al-Hillan, Alsadiq

Alfatlawi, Halah

Bahbah, Eshak

Berengy, Mahmoud

Hassan, Mona

Jamil, Laith

Kobeissy, Abdallah

Merza, Nooraldin

Naguib, Tarek

Nawras, Yusuf

Saab, Omar

English

University of Toledo Open Journal System

The University of Toledo Translation Journal of Medical Sciences Dr. Lance D. Dworkin Department of Medicine Research Symposium             UTJMS 2025 June 30, 13(S3):e1-e6    https://dx.doi.org/10.46570/utjms-2025-1396   ©2025 UTJMS    Submucosal Tunneling Endoscopic Resection for Submucosal Tumors of Less Than 35 mm in the Upper and Lower Gastrointestinal Tract: Systematic Review and Meta-Analysis. Nooraldin Merza1*, Yusuf Nawras2, Halah Alfatlawi3, Eshak Bahbah4, Alsadiq Al-Hillan5, Omar Saab6, Mahmoud Berengy4, Hasan Al Obaidi7, Abdallah Kobeissy8, Mona Hassan9, Tarek Naguib10, Laith Jamil5 1Fellow, Division of Gastroenterology, Department of Medicine, 3000 Arlington Avenue, The University of Toledo, Toledo OH 43615 2Student, College of Medicine and Life Sciences, 3000 Arlington Avenue, The University of Toledo, Toledo OH 43615 3Resident, Division of Internal Medicine, Department of Medicine, 3000 Arlington Avenue, The University of Toledo, Toledo OH 43615 4Al-Azhar University, Internal Medicine Department, Cairo, Egypt 5Corewell Health, Gastroenterology Department, Royal Oak MI 48073 6Internal Medicine Department, Cleveland Clinic, Cleveland OH 7Internal Medicine Department, Jamaica Hospital Medicine Center, Queens NY 11418 8Associate Professor, Associate Program Director for Gastroenterology Fellowship, Division of Gastroenterology, Department of Medicine, 3000 Arlington Avenue, The University of Toledo, Toledo OH 43615 9Assistant Professor, Associate Program Director for Gastroenterology Fellowship, Division of Gastroenterology, Department of Medicine, 3000 Arlington Avenue, The University of Toledo, Toledo OH 43615 10Texas Tech University Health Sciences Center - Amarillo Campus, Internal Medicine, Lubbock TX Email: nmerza@rockets.utoledo.edu Received: 2024-08-16 Accepted: 2024-09-16 Published: 2025-06-30 The University of Toledo Translation Journal of Medical Sciences Dr. Lance D. Dworkin Department of Medicine Research Symposium             UTJMS 2025 June 30, 13(S3):e1-e6    https://dx.doi.org/10.46570/utjms-2025-1396   ©2025 UTJMS    Objectives: We conducted a systematic review and meta-analysis to synthesize the current evidence on the efficacy and safety of submucosal tunneling endoscopic resection (STER) for submucosal tumors (SMTs) of the gastrointestinal (GI) tract (3,4).  Methods: This study adhered to PRISMA guidelines and included observational studies on patients with upper or lower GI tract SMTs who underwent STER (5, 6). Data were extracted from these studies and analyzed using Open Meta[Analyst] and Jamovi software, with outcomes including resection rates, recurrence, and complications. Quality assessment and risk of bias were evaluated using the Newcastle-Ottawa Scale and NIH Quality Assessment Tool, and publication bias was evaluated via funnel plots and regression tests.  Results: This meta-analysis of 27 studies indicated high complete and En-bloc resection rates of 96.1% (95% CI: 94.1% to 98.0%) and 90.3% (95% CI: 85.6% to 94.9%), respectively (1,2,3,7–30). The studies exhibited a low recurrence rate of 2.0% (95% CI: 1.2% to 3.4%) and moderate incidence of complications such as subcutaneous emphysema and pneumomediastinum (10.0%, 95% CI: 5.5% to 17.6%) and pneumothorax (6.6%, 95% CI: 3.9% to 11.0%). Other adverse events like perforation and bleeding were rare, occurring at rates of 2.3% (95% CI: 1.1% to 4.7%) and 2.5% (95% CI: 1.2% to 5.2%), respectively. Furthermore, the average operative time was 59.28 min (95% CI: 53.83 to 64.73), with an average hospital stay of 4.77 days (95% CI: 3.91 to 5.63).  Conclusion: STER demonstrates high resection rates and low recurrence in the treatment of gastrointestinal SMTs. While complications like subcutaneous emphysema, pneumomediastinum, and pneumothorax do occur, they remain low in incidence. 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Submucosal Tunneling Endoscopic Resection for Submucosal Tumors of Less Than 35 mm in the Upper and Lower Gastrointestinal Tract: Systematic Review and Meta-Analysis.

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Submucosal Tunneling Endoscopic Resection for Submucosal Tumors of Less Than 35 mm in the Upper and Lower Gastrointestinal Tract: Systematic Review and Meta-Analysis.

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