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分析方法,以减少大型非形结直肠多的EMR后复发率:间接对对比比较

Dhruvil Radadiya¹, Madhav Desai², Harsh Patel¹

¹Division of Gastroenterology, Department of Internal Medicine, University of Kansas-School of Medicine, Kansas City, Kansas, USA.

Gastrointestinal endoscopy

|December 8, 2023

概括

内镜粘膜切除 (EMR) 加上陷尖软凝血 (STSC) 显著减少了大型非形聚合物去除后的聚合物复发. 水下EMR也在防止多重生方面表现有前途.

科学领域:

胃肠病学胃肠病学
内镜手术是一种内镜手术.
在瘤学瘤学.

背景情况:

尽管内镜粘膜切除 (EMR) 取得了进展,但高息肉复发率仍然存在.
关于聚合体复发的EMR技术的直接比较数据很少.
辅助性热废除和水下EMR是减少复发的潜在策略.

研究的目的:

为了间接比较常规EMR,水下EMR (U-EMR) 和EMR与辅助热移除的复发率.
确定最有效的EMR策略,以防止在大型非形多中复发的多.

主要方法:

系统地搜索到2023年1月之前的电子数据库,以研究大型非脚型息肉 (>15毫米) 的EMR.
包括报告有或没有辅助技术的复发率的研究 (STSC/APC).
频率的间接比较和p-score计算来对干预措施进行排名;通过漏斗图表评估出版偏差.

主要成果:

EMR + STSC显示复发的几率降低了82%,而仅仅是EMR (OR,0.18).
单独U-EMR显示,复发的几率比单独EMR减少了77% (OR,0.23).
与单独使用EMR相比,所有评估的干预措施都显示复发率明显较低,EMR + STSC排名最高.

结论:

EMR + STSC似乎在减少大非形多切除后的多复发方面最有效.
需要进一步标准化EMR方法,以检测残留的息肉并防止复发.

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