提示与常规的内镜粘膜切除结肠直肠新生病:一个系统的审查和元分析
Chengu Niu1, Jay Bapaye1, Jing Zhang2
1Internal Medicine Residency Program.
Journal of clinical gastroenterology
|June 30, 2023
概括
与传统的EMR相比,Tip-in内镜粘膜切除 (EMR) 在结直肠瘤中提供了优异的块状和完整切除率. 这种先进的技术可以实现更好的结果,而不会增加手术时间或并发症.
科学领域:
- 胃肠病学 胃肠病学
- 内視鏡外科手術 內視鏡外科手術
- 在瘤学瘤学.
背景情况:
- 传统的内镜粘膜切除 (C-EMR) 是早期胃肠道瘤的标准.
- C-EMR通常会导致大结直肠病变的不完全切除.
- 尖端内镜粘膜切除 (EMR) 是一种新的技术,旨在进行块切除,最大限度地减少滑动.
研究的目的:
- 系统地审查和元分析比较Tip-in EMR与C-EMR的研究.
- 评估Tip-in EMR与C-EMR在结直肠瘤的疗效和安全性.
- 评估块切除率,完全切除率,手术时间和并发症.
主要方法:
- 11项研究的系统审查和元分析.
- 包括1244个结直肠病变 (684个Tip-in EMR,560个C-EMR).
- 使用随机效应模型分析了块切除,完整切除,手术时间和并发症.
主要成果:
- 与C-EMR相比,提示式EMR显著增加了块切除率 (OR=3.61).
- 提示式EMR显示了比C-EMR更高的完全切除率 (OR=2.49).
- 两种方法之间没有观察到手术时间或并发症率的显著差异.
结论:
- 滴入EMR比C-EMR更有效地实现结直肠病变的块状和完全切除.
- 在没有显著增加手术并发症或时间的情况下,可以实现Tip-in EMR的提高疗效.
- 提示式EMR代表了结直肠瘤内镜切除的进步.
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