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西方的结肠直肠内镜下粘膜切割:一个系统的审查和元分析

Ritu Raj Singh¹, Julie Nanavati², Harishankar Gopakumar³

¹Public Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, United States.

Endoscopy international open

|November 29, 2023

概括

在西方国家,内镜下粘膜切割 (ESD) 对大结直肠多瘤有效,切除率现在与亚洲相当. 虽然穿孔发生在约5%的病例中,但不到2%的病例需要紧急手术.

科学领域:

胃肠病学胃肠病学
内镜检查是指内镜检查.
手术瘤学手术瘤学

背景情况:

在大结直肠瘤中,内镜下粘膜切除 (ESD) 与内镜粘膜切除相比具有优势.
技术挑战和有限的培训阻碍了在西方国家广泛采用ESD.

研究的目的:

在非亚洲国家评估结直肠ESD的有效性.
确定结合的切除率和与结直肠ESD相关的不良事件.

主要方法:

在主要数据库 (Medline,Embase,Web of Science,Cochrane Library) 中进行了系统的文献搜索.
包括在非亚洲国家进行的专注于结直肠ESD的研究.
使用随机效应模型汇集了关于块切除,R0切除和不良事件的数据.

主要成果:

分析了33项涉及3,958项手术的研究,其中96.7%的息肉尺寸≥2厘米.
聚合块切除率为84.6%,R0切除率为75.6%,治愈切除率为81.9%.
与ESD相关的穿孔发生在5.5%,出血发生在4.1%;1.8%的患者因并发症需要手术.

结论:

对大息肉和早期癌症的结肠直肠ESD有效性在西方国家正在改善,其比例与亚洲相当.
虽然结直肠穿孔仍然是一个风险 (约. 5%),由于不良事件而需要紧急手术的需要很低 (<2%).

关键词:

结肠直肠癌是一种癌症.内镜切除 (多眼切除,ESD,EMRc,等等).内镜下部肠道管道下部肠道管道

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