{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T01:57:21Z","timestamp":1790733441529,"version":"4.1.0"},"reference-count":24,"publisher":"The Korean Society of Gastrointestinal Endoscopy","issue":"5","license":[{"start":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T00:00:00Z","timestamp":1790035200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/3.0\/"}],"content-domain":{"domain":["e-ce.org"],"crossmark-restriction":true},"short-container-title":["Clin Endosc"],"published-print":{"date-parts":[[2026,9,30]]},"abstract":"<jats:p>Background\/Aims: Gastrointestinal (GI) cancers accounted for 3.24 million deaths worldwide in 2022. Endoscopic submucosal dissection (ESD) enables en bloc resection of early neoplasms but is time-intensive and technically challenging. Hybrid ESD (H-ESD), which combines dissection with snare polypectomy, may improve efficiency while maintaining efficacy.This Bayesian meta-analysis of randomized controlled trials (RCTs) compares the safety and efficacy of H-ESD with conventional ESD (C-ESD).Methods: We searched the PubMed, Embase, Cochrane, Scopus databases for RCTs comparing hybrid and C-ESD for superficial GI neoplasms. Bayesian modeling in Just Another Gibbs Sampler used normal-normal hierarchies for procedure time and logRR for binary outcomes with weakly informative priors. Frequentist analyses were performed using Der-Simonian-Laird \u03c4\u00b2. Heterogeneity was assessed using I\u00b2\/\u03c4\u00b2.Results: H-ESD showed comparable en bloc (RR, 0.97; 95% [CrI], 0.92\u20131.03; I\u00b2=22.8%) and R0 resection rates (RR, 0.97; 95% CrI, 0.90\u20131.04; I\u00b2=0%). Procedure time decreased significantly with H-ESD (MD, \u201318.05; 95% CrI, \u201327.77 to \u20138.33 minutes; I\u00b2=66.5%). Adverse events (RR, 1.08; 95% CrI, 0.44\u20132.63) and perforations (RR, 1.05; 95% CrI, 0.34\u20133.19) were similar between the two procedures.Conclusions: H-ESD matches C-ESD in curative resection while reducing the procedure time, offering a safer and more efficient alternative. Larger RCTs are needed to confirm the long-term benefits.<\/jats:p>","DOI":"10.5946\/ce.2025.439","type":"journal-article","created":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T07:53:23Z","timestamp":1790063603000},"page":"754-764","update-policy":"https:\/\/doi.org\/10.5946\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Hybrid endoscopic submucosal dissection enhances efficiency with comparable curative outcomes: a Bayesian meta-analysis, systematic review, and Monte Carlo simulation of randomized controlled trials"],"prefix":"10.5946","volume":"59","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-8717-6108","authenticated-orcid":true,"given":"Ashesh","family":"Das","sequence":"first","affiliation":[{"name":"Department of Gastroenterology, Sri Padmavathi Medical College for Women, SVIMS, Tirupati, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-4372-5327","authenticated-orcid":true,"given":"Arpitha Sirichandana","family":"Baggu","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-4100-6271","authenticated-orcid":true,"given":"Param Darpan","family":"Sheth","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, JSS Medical College, JSS Academy of Higher Education and Research, Mysuru, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-2052-292X","authenticated-orcid":true,"given":"Nihal Reddy","family":"Bandi","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, E.S.I.C Medical College and Hospital, Hyderabad, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-1935-1798","authenticated-orcid":true,"given":"Chandana Priya","family":"Digumurthy","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Apollo Institute of Medical Sciences and Research, Chittoor, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-3258-0814","authenticated-orcid":true,"given":"Urvashi","family":"Bharia","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Lokmanya Tilak Municipal Medical College and General Hospital, Mumbai, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7136-5830","authenticated-orcid":true,"given":"Shah Kavya","family":"Hiteshkumar","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, GMERS Medical College, Himmatnagar, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-7771-6880","authenticated-orcid":true,"given":"Krishna Sai Kiran","family":"Sakalabaktula","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Tulane University School of Medicine, New Orleans, LA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-2421-3953","authenticated-orcid":true,"given":"Shankar","family":"Biswas","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Ivano-Frankivsk National Medical University, Ivano-Frankivsk, Ukraine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-7882-695X","authenticated-orcid":true,"given":"Riyakumari","family":"Patel","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Surat Municipal Institute of Medical Education and Research, Surat, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-9128-7428","authenticated-orcid":true,"given":"Meenakshi Reddy","family":"Yathindra","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Kasturba Medical College, Mangalore, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-3894-9698","authenticated-orcid":true,"given":"Venkata Dileep Kumar","family":"Veldi","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Gayatri Vidhya Parishad Institute of Health Care and Medical Technology, Visakhapatnam, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"3961","reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21834","type":"journal-article"},{"key":"ref2","volume-title":"Global cancer observatory: cancer tomorrow (projections to 2050) [Internet]","year":"2025","type":"web-resource"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1055\/a-1811-7025","type":"journal-article"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v29.i19.2916","type":"journal-article"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2018.01.068","type":"journal-article"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1055\/s-0042-114774","type":"journal-article"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1016\/j.igie.2023.03.007","type":"journal-article"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1055\/a-1266-1855","type":"journal-article"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n71","type":"journal-article"},{"key":"ref10","volume-title":"Cochrane handbook for systematic reviews of interventions version 6.4 (updated August 2023) [Internet]","author":"Higgins","year":"2023","type":"web-resource"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.l4898","type":"journal-article"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.14.2962","type":"journal-article"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2015.06.057","type":"journal-article"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2022.10.030","type":"journal-article"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.14309\/ajg.0000000000002897","type":"journal-article"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.55645","type":"journal-article"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v22.i26.5927","type":"journal-article"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v17.i31.3575","type":"journal-article"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.1007\/s10620-019-05822-0","type":"journal-article"},{"key":"ref20","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v24.i23.2518","type":"journal-article"},{"key":"ref21","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2018.07.041","type":"journal-article"},{"key":"ref22","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2017.02.024","type":"journal-article"},{"key":"ref23","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2020.12.048","type":"journal-article"},{"key":"ref24","doi-asserted-by":"publisher","DOI":"10.1111\/1467-9868.00353","type":"journal-article"}],"container-title":["Clinical Endoscopy"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/e-ce.org\/upload\/pdf\/ce-2025-439.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/e-ce.org\/journal\/view.php?doi=10.5946\/ce.2025.439","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/e-ce.org\/upload\/pdf\/ce-2025-439.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T01:28:16Z","timestamp":1790731696000},"score":1,"resource":{"primary":{"URL":"http:\/\/e-ce.org\/journal\/view.php?doi=10.5946\/ce.2025.439"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,30]]},"references-count":24,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2026,9]]}},"URL":"https:\/\/doi.org\/10.5946\/ce.2025.439","relation":{},"ISSN":["2234-2400","2234-2443"],"issn-type":[{"value":"2234-2400","type":"print"},{"value":"2234-2443","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,30]]},"assertion":[{"value":"2025-11-24","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-29","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-22","order":2,"name":"published","label":"Published online","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-30","order":3,"name":"published","label":"Print publication","group":{"name":"publication_history","label":"Publication History"}}]}}