Effectiveness and safety of stag beetle knife (SB knife) in management of Zenker’s diverticulum: a systematic review and meta-analysis

Author:

Dahiya Dushyant Singh12,Deliwala Smit3,Chandan Saurabh4,Ramai Daryl5,Ali Hassam6,Kassab Lena L7,Facciorusso Antonio89,Kochhar Gursimran S10

Affiliation:

1. Division of Gastroenterology , Hepatology & Motility, , Kansas City, KS , USA

2. The University of Kansas School of Medicine , Hepatology & Motility, , Kansas City, KS , USA

3. Division of Digestive Diseases, Emory University School of Medicine , Atlanta, GA , USA

4. Division of Gastroenterology & Hepatology, CHI Creighton University Medical Center , Omaha, NE , USA

5. Department of Gastroenterology, University of Utah , Salt Lake City, UT , USA

6. Division of Gastroenterology and Hepatology, East Carolina University/Brody School of Medicine , Greenville, NC , USA

7. Department of Internal Medicine, Mayo Clinic , Rochester, MN , USA

8. Gastroenterology Unit , Department of Surgical and Medical Sciences, , Foggia , Italy

9. University of Foggia , Department of Surgical and Medical Sciences, , Foggia , Italy

10. Division of Gastroenterology, Hepatology & Nutrition, Allegheny Health Network , Pittsburgh, PA , USA

Abstract

Summary Stag Beetle Knife (SB Knife) is increasingly being utilized for Zenker’s Diverticulectomy (ZD). Our study assessed the effectiveness and safety of the SB Knife for the management of ZD. Ovid EBM reviews, Ovid Embase, Ovid Medline, ClinicalTrials.gov, Scopus, and Web of Science were searched to identify studies that utilized SB knife for ZD. Pooled proportions (PP) were calculated using the random-effects model. Heterogeneity was evaluated using I2 statistics. A total of 7 studies with 268 patients were included in the final analysis. Dysphagia and regurgitation were the most common clinical symptoms. The mean size of the ZD was 2.8 ± 0.7 cm and 28 (of 148) patients had undergone previous treatments. The PP of technical success was 98% (95% CI: 92.3–99.5; I20) with a mean procedure duration of 26.2 ± 8.3 minutes. The PP of clinical response at first follow-up and relapse after index procedure was 87.9% (95% CI: 81.6–92.3; I219) and 13.5% (95% CI: 9.6–18.6; I22), respectively. At final follow-up, the PP of clinical remission was 96.2% (95% CI: 91–98.4; I230.6) while the PP of procedure failure was 3.6% (95% CI: 1.6–8.1; I20). No severe adverse events (AEs) were noted while using the SB Knife. However, the PP of intraprocedural and postprocedural AEs was 13.2% (95% CI: 9.6–17.8; I20) and 9.3% (95% CI: 5.7–14.9; I2 < 20.9), respectively. SB Knife is highly safe and effective for Zenker’s Diverticulectomy with a failure rate of only 3.6%.

Publisher

Oxford University Press (OUP)

Subject

Gastroenterology,General Medicine

Reference41 articles.

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