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对于结肠直肠瘤的常规对引力内镜下粘膜剖析:随机对照试验的元分析

Sahib Singh¹, Babu P Mohan², Saurabh Chandan³

¹Internal Medicine, Sinai Hospital of Baltimore, Baltimore, MD.

Journal of clinical gastroenterology

|January 22, 2024

概括

与传统的内镜下粘膜剖析 (C-ESD) 相比,拉力内镜下粘膜剖析 (T-ESD) 为结直肠病变提供了更快的程序时间. 然而,这两种方法都显示出可比的临床结果,包括R0切除和并发症率.

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
在瘤学瘤学.

背景情况:

传统的内镜下粘膜剖析 (C-ESD) 是对结直肠病变的标准技术.
拉力内镜下层剖析 (T-ESD) 旨在改善病变稳定性和易于剖析.
关于T-ESD与C-ESD的临床结果存在相互矛盾的结果.

研究的目的:

进行对结直肠瘤T-ESD和C-ESD进行比较的元分析.
为了评估手术时间,切除速度和关键切除结果的差异.
评估这两种内镜剖析技术的安全性.

主要方法:

在多个数据库中系统地搜索相关的随机对照试验 (RCT).
包括6个RCT,共566名患者 (284名C-ESD,282名T-ESD).
使用随机效应模型进行元分析,以比较手术时间,切除速度,R0切除,块切除,延迟出血和穿孔.

主要成果:

与C-ESD相比,T-ESD与明显缩短的手术时间 (SMD 0.91) 和更快的切除速度 (SMD -1.03) 相关.
在R0切除率 (RR 1.00),块切除率 (RR 0.99),延迟出血率 (RR 0.66) 或穿孔率 (RR 2.16) 中没有观察到T-ESD和C-ESD之间的显著差异.

结论:

与C-ESD相比,T-ESD显著减少了手术时间,并增加了结直肠病变的切除速度.
对T-ESD和C-ESD的临床结果和安全概况是可比的.
在不影响瘤或安全终点的情况下,T-ESD代表了C-ESD的潜在更有效的替代品.

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