寒冷或热内镜性粘膜切除对于10毫米以上的状结肠直肠聚体:系统性审查和元分析
Talia F Malik1, Babu P Mohan2, Smit Deliwala3
1Department of Internal Medicine, Chicago Medical School at Rosalind Franklin University of Medicine and Science, North Chicago, IL.
Journal of clinical gastroenterology
|November 29, 2023
概括
寒冷内镜粘膜切除 (EMR) 对于大状状息肉 (SSP) 是热EMR一样有效. 这两种方法都显示出类似的残留聚率,但热EMR具有更高的延迟出血风险.
科学领域:
- 胃肠病学 胃肠病学
- 内镜检查是指内镜检查.
- 在瘤学瘤学.
背景情况:
- 长度≥10毫米的形形息肉 (SSPs) 构成了切除的挑战.
- 内镜粘膜切除 (EMR) 是SSP去除的一个关键技术.
- 将冷与热EMR进行比较对于优化患者治疗结果至关重要.
研究的目的:
- 系统地审查和元分析冷与热EMR的有效性和安全性,用于SSPs≥10mm.
- 为了比较SSP残留率,技术成功,R0切除和冷和热EMR之间的不良事件.
- 为SSP管理提供基于证据的建议.
主要方法:
- 对比冷热EMR的SSP≥10毫米的研究进行系统审查和元分析.
- 搜索了多个数据库,直到2023年1月.
- 主要结果:剩余的SSP利率. 二次结果:技术成功,R0切除和不良事件.
主要成果:
- 分析了13项使用1896个SSP (平均尺寸为23.7毫米) 的研究.
- 剩余的SSP率是可比的:冷EMR为4.5%,热EMR为5.1% (P=0.9).
- 与冷EMR相比,热EMR显示出更高的阻断切除 (41.4%对1.4%),但延迟出血增加 (4%对0.7%).
结论:
- 对于大型SSP切除,冷EMR的疗效与热EMR的疗效相当.
- 热EMR提供更高的阻断切除率,但与延迟出血风险的增加有关.
- 进一步的研究可能会根据多体大小和特征澄清SSP的最佳EMR技术.
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