小结直肠息肉的薄与厚冷陷多角切除术的有效性和安全性:系统性审查和元分析
Rishad Khan1, Sunil Samnani1, Marcus Vaska2
1Department of Medicine, University of Toronto, Toronto, Canada.
Endoscopy international open
|January 22, 2024
概括
使用细线或厚线陷的冷陷多角切除术 (CSP) 在去除小结直肠息肉方面表现出类似的有效性. 这一元分析证实CSP是一种安全可靠的方法,不管使用的是什么厚度的绳索.
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
- 医疗技术评估 医疗技术评估
背景情况:
- 冷诱多角切除术 (CSP) 是切除最大10毫米的结直肠多瘤的标准.
- 关于在CSP中比较薄电线与厚电线陷的有效性,存在相互矛盾的数据.
- 进行了一项元分析,以比较这些陷类型.
研究的目的:
- 为了比较使用薄电线与厚电线陷的CSP的完整切除 (CR) 率.
- 评估和比较与两种陷类型相关的不良事件率.
- 确定最佳的陷类型,以安全有效地去除结肠直肠多.
主要方法:
- 对比研究的元分析,包括随机对照试验 (RCT) 和观察性研究.
- 纳入标准:成年患有大肠直肠多体≤10毫米的患者用薄线或厚线进行CSP.
- 评估结果:CR率,聚检索,出血,穿孔,患者不适,镇静和手术时间.
主要成果:
- 分析了四个RCT和两项观察性研究,涉及1316名患者和1679个多.
- 在薄电线 (92.1%在RCT中) 和厚电线 (87.7%在RCT中) 之间没有发现CR率的显著差异.
- 在聚取出或手术内出血方面没有观察到显著差异;没有报告延迟出血或穿孔.
结论:
- 薄电线和厚电线陷显示,CSP的完全切除率相似.
- CSP是一种安全有效的内镜手术,用于小结直肠多体,不论线的厚度如何.
- 在薄丝网和厚丝网之间做出选择似乎不会影响程序结果或安全.
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