Prophylactic Mechanical Closure for Preventing Delayed Bleeding after Gastric Endoscopic Submucosal Dissection: A Systematic Review and Meta-Analysis.

ABSTRACT:

Background

Delayed bleeding remains the most common adverse event after gastric endoscopic submucosal dissection (ESD). We assessed whether prophylactic mechanical closure is associated with reduced clinically significant delayed bleeding.

Methods

PubMed, Embase, Cochrane CENTRAL, Scopus, and ClinicalTrials.gov were searched through October 2025. Comparative studies reporting delayed bleeding within 30 days were included. Random-effects meta-analysis with Hartung-Knapp-Sidik-Jonkman adjustment was applied. Evidence certainty was assessed using GRADE.

Results

Nine studies (2646 patients; eight non-randomized) met inclusion criteria. Prophylactic closure was associated with reduced delayed bleeding (risk ratio [RR] 0.36, 95% confidence interval [CI] 0.16-0.82; p

SUBMITTER: Yodying H 

PROVIDER: S-EPMC12906296 | biostudies-literature | 2026 Apr

REPOSITORIES: biostudies-literature