附加设备与投影对查结肠镜的影响:系统性审查和元分析
Magdalini Manti1, Georgios Tziatzios1, Antonio Facciorusso2
1Department of Gastroenterology, "Konstantopoulio Patision" General Hospital of Nea Ionia, Athens, Greece (Magdalini Manti, Georgios Tziatzios, Konstantina Paraskeva, Paraskevas Gkolfakis).
结肠镜的附加设备在癌症查期间显著增加了腺瘤检测率 (ADR). 与标准结肠镜检查 (SC) 相比,这些设备可以更好地检测癌前病变.
科学领域:
- 胃肠病学 胃肠病学
- 医疗器械 医疗器械
- 癌症查 癌症查
背景情况:
- 具有投影的附加设备 (例如,Endocuff,EndoRings) 旨在增强在结肠镜检查期间的癌前病变检测.
- 它们在查结肠镜检查期间改善腺瘤检测率 (ADR) 的有效性需要严格评估.
研究的目的:
- 在结肠镜查中进行元分析,评估附加设备与投影的性能.
- 为了比较腺瘤检测率 (ADR) 和标准结肠镜 (SC) 和SC与附加设备之间的其他关键指标.
主要方法:
- 系统地搜索MEDLINE和Cochrane图书馆的文献,寻找随机对照试验,将SC与附加设备进行比较.
- 主要结局:腺瘤检测率 (ADR). 二次结果:多体检测率 (PDR),高级腺瘤检测率 (AADR),形形损伤检测率 (SSLDR).
- 随机效应模型用于计算风险比率 (RR) 和95%置信区间 (CI).
主要成果:
- 包括7项涉及5785名患者的研究. 附加设备显著增加了ADR (45.9%与41.1%相比;RR1.18,P=0.03).
- 多胞胎检测率 (PDR) 与附加设备相比较高,但在统计学上并不显著 (55.1%与50.8%相比;RR 1.10,P=0.17).
- 在AADR (18.5%对17.6%;RR 1.00,P=0.98) 或SSLDR (6.8%对5.8%;RR 1.17,P=0.15) 中没有发现显著差异.
结论:
- 使用带有投影的附加设备进行结肠镜检查,与查人群的标准结肠镜检查相比,显示出改善的不良反应.
- 这些设备显示出在结直肠癌查期间增强癌前病变的检测潜力.
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