Skip Navigation
Skip to contents

Clin Endosc : Clinical Endoscopy


Author index

Page Path
HOME > Browse Articles > Author index
Sunil Upadhaya 1 Article
Carbon Dioxide versus Air Insufflation in Gastric Endoscopic Submucosal Dissection: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
Ramkaji Baniya, Sunil Upadhaya, Jahangir Khan, Suresh K Subedi, Tabrez S Mohammed, Balvant K Ganatra, Ghassan Bachuwa
Clin Endosc 2017;50(5):464-472.   Published online May 18, 2017
AbstractAbstract PDFPubReaderePub
/Aims: Endoscopic submucosal dissection (ESD) with air insufflation is commonly used for the staging and treatment of early gastric carcinoma. However, carbon dioxide (CO2) use has been shown to cause less post-procedural pain and fewer adverse events. The objective of this study was to compare the post-procedural pain and adverse events associated with CO2 and air insufflation in ESD.
A systematic search was conducted for randomized control trials (RCTs) comparing the two approaches in ESD. The Mantel-Haenszel method was used to analyze the data. The mean difference (MD) and odds ratio (OR) were used for continuous and categorical variables, respectively.
Four RCTs with a total of 391 patients who underwent ESD were included in our meta-analysis. The difference in maximal post-procedural pain between the two groups was statistically significant (MD, -7.41; 95% confidence interval [CI], -13.6 – -1.21; p=0.020). However, no significant differences were found in the length of procedure, end-tidal CO2, rate of perforation, and postprocedural hemorrhage between the two groups. The incidence of overall adverse events was significantly lower in the CO2 group (OR, 0.51; CI, 0.32–0.84; p=0.007).
CO2 insufflation in gastric ESD is associated with less post-operative pain and discomfort, and a lower risk of overall adverse events compared with air insufflation.


Citations to this article as recorded by  
  • Management of perforations during endoscopic resection
    Ludovico Alfarone, Marco Spadaccini, Alessandro Repici, Cesare Hassan, Roberta Maselli
    Best Practice & Research Clinical Gastroenterology.2024; 69: 101900.     CrossRef
  • Prevention of post-ERCP complications
    Lotfi Triki, Andrea Tringali, Marianna Arvanitakis, Tommaso Schepis
    Best Practice & Research Clinical Gastroenterology.2024; 69: 101906.     CrossRef
  • Endoscopic submucosal dissection techniques and technology: European Society of Gastrointestinal Endoscopy (ESGE) Technical Review
    Diogo Libânio, Pedro Pimentel-Nunes, Barbara Bastiaansen, Raf Bisschops, Michael J. Bourke, Pierre H. Deprez, Gianluca Esposito, Arnaud Lemmers, Philippe Leclercq, Roberta Maselli, Helmut Messmann, Oliver Pech, Mathieu Pioche, Michael Vieth, Bas L.A.M. We
    Endoscopy.2023; 55(04): 361.     CrossRef
  • The future of endoscopic resection for early gastric cancer
    Raquel Ortigão, Diogo Libânio, Mário Dinis‐Ribeiro
    Journal of Surgical Oncology.2022; 125(7): 1110.     CrossRef
  • Massive pneumoperitoneum with abdominal pain and fever mimicking delayed perforation following endoscopic resection: A case report
    Jen‐Hao Yeh, Jen‐Chieh Chen, Chia‐Chang Hsu, Wen‐Lun Wang, Chih‐Wen Lin
    Advances in Digestive Medicine.2021; 8(2): 121.     CrossRef
  • Diagnosis and Management of Iatrogenic Endoscopic Retrograde Cholangiopancreatography Perforations Based on the European Society of Gastrointestinal Endoscopy Position Statement
    Young Jung Kim, Chang Hwan Park
    The Korean Journal of Medicine.2021; 96(4): 318.     CrossRef
  • Endoscopic submucosal dissection: How to be more efficient?
    Thomas Lambin, Jérôme Rivory, Timothée Wallenhorst, Romain Legros, Frédéric Monzy, Jérémie Jacques, Mathieu Pioche
    Endoscopy International Open.2021; 09(11): E1720.     CrossRef
  • Diagnosis and management of iatrogenic endoscopic perforations: European Society of Gastrointestinal Endoscopy (ESGE) Position Statement – Update 2020
    Gregorios A. Paspatis, Marianna Arvanitakis, Jean-Marc Dumonceau, Marc Barthet, Brian Saunders, Stine Ydegaard Turino, Angad Dhillon, Maria Fragaki, Jean-Michel Gonzalez, Alessandro Repici, Roy L.J. van Wanrooij, Jeanin E. van Hooft
    Endoscopy.2020; 52(09): 792.     CrossRef
  • Effectiveness of Autologous Platelet-Rich Plasma for the Healing of Ulcers after Endoscopic Submucosal Dissection
    Eunju Jeong, In kyung Yoo, Ozlem Ozer Cakir, Hee Kyung Kim, Won Hee Kim, Sung Pyo Hong, Joo Young Cho
    Clinical Endoscopy.2019; 52(5): 472.     CrossRef
  • Carbon Dioxide Insufflation in Endoscopic Submucosal Dissection: Is It an Urgent Need?
    Chang Seok Bang, Gwang Ho Baik
    Clinical Endoscopy.2017; 50(5): 407.     CrossRef
  • 9,307 View
  • 149 Download
  • 10 Web of Science
  • 10 Crossref
Close layer

Clin Endosc : Clinical Endoscopy Twitter Facebook
Close layer