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A comprehensive meta-analysis of randomized controlled trials compared traction-assisted ESD versus conventional ESD. Outcomes assessed procedure time, en bloc and R0 resection completeness, and safety including perforation and delayed bleeding, with prespecified subgroup analyses.",{"@graph":69,"@context":115},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/efficacy-and-safety-of-traction-assisted-endoscopic-submucosal-dissection-for-superficial-gastric-neoplasms-a-meta-analysis-of-randomized-controlled-trials/360503/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/efficacy-and-safety-of-traction-assisted-endoscopic-submucosal-dissection-for-superficial-gastric-neoplasms-a-meta-analysis-of-randomized-controlled-trials/360503.png","ImageObject",300,407,{"name":92,"@type":93},"Grenda","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-28","2026-09-23",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",12,{"@type":107,"mainEntity":108},"FAQPage",[109],{"name":110,"@type":111,"acceptedAnswer":112},"Did traction-assisted ESD change safety outcomes like perforation or delayed bleeding?","Question",{"text":113,"@type":114},"Traction-assisted ESD reduced perforation risk substantially while maintaining a comparable delayed bleeding rate. 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Front. Oncol. 16:1824135 .  \ndoi: 10.3389/fonc.2026.1824135  \nCOPYRIGHT  \n© 2026 Zhao, Xu, Zhang, Li, Yang, Wang and Xie. This is an open-access article distributed under the terms of the  \nCreative Commons Attribution License (CC BY) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.  \nEfficacy and safety of tractionassisted endoscopic submucosal dissection for superficial gastric neoplasms: a meta-analysis of randomized controlled trials  \nZhen-guang Zhao 1†, Wen-guang Xu 2†, Rui Zhang 3†, Xiao-mei Li 4, Chen Yang4, Li Wang 5* and Jing Xie 6*  \n1 Department of Gastroenterology, Beijing Puxiang Hospital of Traditional Chinese Medicine (TCM), Beijing, China, 2 Department of Gastroenterology, The Affiliated Qingdao Third People ’s Hospital of Qingdao University, Qingdao, Shandong, China, 3 Department of Emergency Medicine, Rocket Force Characteristic Medical Center, Beijing, China, 4 Laoshan Medical District of No. 971 Hospital of Chinese Navy, Qingdao, Shandong, China, 5 Department of Oncology, Sunshine Union Hospital, Weifang, China, 6 Department of Gastroenterology, Rocket Force Characteristic Medical Center, Beijing, China  \nBackground: Endoscopic submucosal dissection (ESD) remains technically demanding for superficial gastric neoplasms, particularly during submucosal layer dissection which is often time-consuming and associated with procedural risks. While traction-assisted ESD has been proposed to enhance visualization and facilitate safer dissection, current evidence regarding its efficacy and safety remains inconsistent.  \nMethods: We conducted a comprehensive meta-analysis of randomized controlled trials (RCTs) comparing traction-assisted versus conventional ESD for superficial gastric neoplasms. Primary outcome was procedure time, with secondary outcomes were resection completeness (en bloc and R0 rates) . Safety outcomes focused on adverse events (perforation and delayed bleeding) . Subgroup analyses were performed by lesion size, lesion location, operator experience level and study design.  \nResults: Seven RCTs involving 1476 patients were included. Meta-analysis demonstrated that traction-assisted ESD significantly reduced procedure time compared to conventional ESD (SMD: -0. 23, 95% CI: -0.44 to-0. 02; P = 0 . 034), with particularly pronounced benefits for lesions ≤20mm (SMD: -0.39, 95% CI:-0. 69 to-0. 09, P = 0 . 011) and those located at the greater curvature of the upper/ middle stomach (SMD: -0. 58, 95% CI: -0. 98 to-0. 19; P = 0 . 004) . However, the benefit was operator-dependent: traction-assisted ESD significantly reduced procedure time in beginners (SMD: -0. 22, 95% CI: -0.40 to -0. 04; P = 0 . 019) but not in experts (SMD: -0. 08, 95% CI: -0. 22 to 0 . 06; P = 0 . 250) . Resection quality remained comparable between groups, with similar en bloc (RR: 1 . 00, 95% CI: 0 .99-1. 01; P = 1 . 00","cbCaiibBPGZmXed6","https://ap.wps.com/l/cbCaiibBPGZmXed6","pdf",2891058,"English","# Introduction\n## Background and clinical challenges\n# Methods\n## Study design and outcomes\n# Results\n## Procedure time, resection quality, and adverse events\n## Subgroup analyses\n# Conclusions\n## Clinical implications and limitations","[{\"question\":\"Did traction-assisted ESD change safety outcomes like perforation or delayed bleeding?\",\"answer\":\"Traction-assisted ESD reduced perforation risk substantially while maintaining a comparable delayed bleeding rate. Resection quality indicators (en bloc and R0 rates) were similar between groups.\"}]","Efficacy and safety of traction-assisted endoscopic submucosal dissection for superficial gastric neoplasms - a meta-analysis of randomized controlled trials | PDF",1790140306,25]