biostudies-literatureUnknown6(1)Yodying H<h4>Background</h4>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.<h4>Methods</h4>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.<h4>Results</h4>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; <i>p</i> DEN opene70299https://www.ebi.ac.uk/biostudies/studies/S-EPMC12906296biostudies-literatureProphylactic Mechanical Closure for Preventing Delayed Bleeding after Gastric Endoscopic Submucosal Dissection: A Systematic Review and Meta-Analysis.PMC12906296Prapasajchavet WBoonsinsukh TPetchkaewkul PLaojanun RRookkachart TSathornviriyapong SMekrugsakit NChartkitcharoen AViriyaroj VYodying HfalseProphylactic Mechanical Closure for Preventing Delayed Bleeding after Gastric Endoscopic Submucosal Dissection: A Systematic Review and Meta-Analysis.<h4>Background</h4>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.<h4>Methods</h4>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.<h4>Results</h4>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; <i>p</i> 2026-01-01T00:00:00Z2026 Apr2026-07-15T22:15:54.761Z2026-07-09T10:20:53.785ZS-EPMC129062964169373910.1002/deo2.70299