由于牵引力和可视化有限，内镜粘膜下剥离术（ESD）治疗胃肿瘤可能具有挑战性。牵引辅助内镜粘膜下剥离术（TA-ESD）的疗效仍需要进一步验证。本研究旨在探讨 TA-ESD 与传统内镜粘膜下剥离术 (C-ESD) 相比，治疗不同部位早期胃肿瘤的安全性和有效性。我们使用截至 2022 年 8 月的数据库进行了全面的文献检索。结果测量手术时间、整块切除率、完全切除率、手术时间和手术相关不良事件发生率。我们计算了这些结果的汇总平均差 (MD) 和比值比 (OR)。与 C-ESD 组相比，TA-ESD 组的平均手术时间显着缩短 (MD - 14.9, 95% CI - 21.78 至 - 8.03，I2 = 83%，p < 0.0001）。亚组分析显示，TA-ESD 组中胃大弯和上/中胃病变的平均手术时间显着缩短 - 19.2 分钟（95% CI - 27.75 至 - 10.65，I2 = 12%，p < 0.0001 ）和 - 7.35 分钟（95% CI - 35.4 至 - 1.15，p = 0.04）。两组的整块切除率和完全切除率相当。 TA-ESD 组的穿孔率显着低于 C-ESD 组（OR 0.36，95% CI 0.15-0.85，p = 0.02，I2 = 0%）。这项研究证明了 TA-ESD 的潜在益处ESD 相对于 C-ESD 治疗早期胃肿瘤患者，突出了其安全性和有效性。研究结果表明，与 C-ESD 相比，TA-ESD 在具有挑战性的胃部部位的手术时间显着缩短。© 2023。作者获得 Springer Science Business Media, LLC（Springer Nature 旗下公司）的独家许可。

Endoscopic submucosal dissection (ESD) for gastric neoplasms can be challenging due to limited traction and visualization. The efficacy of traction-assisted endoscopic submucosal dissection (TA-ESD) continues to require additional validation. This study aims to explore the safety and efficiency of TA-ESD for early gastric neoplasms located at varying sites, in comparison with conventional endoscopic submucosal dissection (C-ESD).We conducted a comprehensive literature search using databases up until August 2022. The outcome measures procedure time, en bloc resection rate, complete resection rate, procedure time, and procedure-related adverse event rate. We calculated pooled mean differences (MDs) and odds ratios (ORs) for these outcomes.The mean procedure time was significantly shorter in the TA-ESD group compared to the C-ESD group (MD - 14.9, 95% CI - 21.78 to - 8.03, I2 = 83%, p < 0.0001). Subgroup analysis revealed that mean procedure times for lesions on the greater curvature and upper/middle of the stomach were significantly shorter in the TA-ESD group - 19.2 min (95% CI - 27.75 to - 10.65, I2 = 12%, p < 0.0001) and - 7.35 min (95% CI - 35.4 to - 1.15, p = 0.04), respectively. The en bloc resection and complete resection rates were comparable between the two groups. The rate of perforation was significantly lower in the TA-ESD group than in the C-ESD group (OR 0.36, 95% CI 0.15-0.85, p = 0.02, I2 = 0%).This study demonstrates the potential benefits of TA-ESD over C-ESD in treating patients with early-stage gastric tumors, highlighting its safety and efficacy. The findings indicate a significant reduction in procedure times at challenging stomach sites with TA-ESD in comparison to C-ESD.© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.