The University of Toledo Translation Journal of Medical Sciences 
Gastroenterology Abstract, Department of Medicine Research Symposium UTJMS 2023 May 5; 11(1):e1-e2 

Efficacy and Safety of Cap Assisted vs. 
Conventional Endoscopic Esophageal 
Foreign Body Removal- Systematic Review 
and Meta-analysis 

Anas Renno1*, Zohaib Ahmed MD1, Syeda Faiza Arif MD1, Stephanie Lin Ong MD1, 
Joyce Badal MD1, Wade lee-Smith MLS2, Umer Farooq MD1, Muhammad Aziz 
MD1, Yaseen Alastal MD1, Ali Nawras MD1 

1Division of Gastroenterology and Hepatology, Department of Medicine, The 
University of Toledo, Toledo, OH 43614 
2Department of University Libraries, The University of Toledo, Toledo, OH 43614 

*Corresponding author: anas.renno@utoledo.edu

Published: 05 May 2023 

Introduction: Foreign body impaction (FBI) is a common endoscopic emergency in clinical practice. 
FBI can be food (also known as a "food bolus (FB)") or other impactions (non-food). We conducted a 
comprehensive systematic review and meta-analysis to compare cap-assisted and conventional 
endoscopic techniques for removing esophageal foreign body impaction. 

Methods: A comprehensive search technique was utilized to identify studies that used capped 
endoscopic devices to remove food boluses or other esophageal foreign bodies. The primary outcomes 
were the technical success rate, rate of en bloc retrieval, and procedure time. Secondary outcomes were 
overall complications, mucosal tear, bleeding, and perforation. Odds Ratio (OR) with 95% confidence 
intervals (CI) were estimated using random effects models and the DerSimonian-Laird technique.  

Results: Seven studies with a total of 1407 patients were included. The included patients' mean age was 
55.3+/- 7.2 years, and the male percentage was 44.8%. There were two RCTs and five observational 
studies among the included studies. The technical success rate was significantly higher in the cap-
assisted group compared to the conventional group (OR: 3.47, CI: 1.68-7.168, I2=0%, p=<0.001). The 
en bloc retrieval rate was significantly higher in the cap-assisted group compared to the conventional 
group (OR: 26.90, CI: 17.82-40.60, I2=0%, p=0.001). The overall adverse events were significantly 
lower in the cap-assisted group compared to the conventional group (OR: 0.118, CI: 0.018-0.792, 
I2=81.79%, p=0.02).  

https://dx.doi.org/10.46570/utjms.vol11-2023-685 

https://dx.doi.org/10.46570/utjms.vol11-2023-685
mailto:anas.renno@utoledo.edu


https://dx.doi.org/10.46570/utjms.vol11-2023-685 UTJMS 11(1):e1-e2 

https://dx.doi.org/10.46570/utjms.vol11-2023-685 2 ©2023 UTJMS 

Conclusion: This systematic review and meta-analysis showed that the cap-assisted technique has 
higher efficacy and better safety than conventional techniques. However, larger randomized control 
trials are needed to validate these results. 

https://dx.doi.org/10.46570/utjms.vol11-2023-685
https://dx.doi.org/10.46570/utjms.vol11-2023-685