结直肠内镜下粘膜剖析失败的危险因素:系统性审查和元分析
Feng Gu1, Wei Jiang2, Jingyi Zhu1
1Department of Gastroenterology, Xuanwu Hospital, Capital Medical University, Beijing 100053, China.
概括
大型结直肠瘤 (≥40-50毫米),右侧位置,深层侵袭和纤维化增加了不完整的内镜下粘膜解剖 (ESD) 或穿孔的风险. 没有确定延迟出血的危险因素.
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
背景情况:
- 内镜下粘膜切割 (ESD) 越来越多地用于结直肠瘤,但在技术上仍然具有挑战性.
- 导致ESD故障的因素需要进一步阐明.
研究的目的:
- 系统地审查和识别与不成功的结直肠内镜下粘膜切割 (ESD) 相关的风险因素.
主要方法:
- 对Medline和Embase数据库进行了全面的文献搜索.
- 不成功的ESD被定义为不完整的切除或不良事件 (穿孔,延迟出血).
- 对来自23个队列和16个病例控制研究的数据进行了元分析.
主要成果:
- 损伤直径≥40或50毫米,右侧结肠位置,更深的下层侵袭和严重的纤维化是不完全切除的重要风险因素.
- 大的病变直径 (≥40或50毫米) 和严重的纤维化是穿孔的危险因素.
- 从统计学上来看,没有任何特定因素与延迟出血有关.
结论:
- 这次元分析确定了不完全切除和结直肠ESD中不良事件的关键风险因素.
- 这些发现有助于临床医生识别高风险患者,以改善决策.
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