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内镜下粘膜切割vs直肠瘤的过内镜手术:系统性审查和元分析

Long-Wu Huang¹, Ying Zhong²

¹Department of Gastroenterology, Huzhou Third Municipal Hospital, the Affiliated Hospital of Huzhou University, Huzhou 313000, Zhejiang Province, China.

World journal of clinical cases

|January 31, 2024

概括

内镜下粘膜切割 (ESD) 和过内镜下粘膜切割 (TES) 的疗效和安全性相似. 患者和外科医生的因素可以指导这些内镜切除技术之间的选择.

科学领域:

胃肠病学和外科内镜术
最少侵入性的外科技术.
相对有效性研究研究比较

背景情况:

内镜下粘膜切割 (ESD) 和过内镜下粘膜切割 (TES) 是已建立的内镜切割技术.
与TES相比,ESD的比较有效性和安全性需要进一步澄清.

研究的目的:

系统地比较ESD和TES之间的手术结果.
为了确定复发率,切除率和并发症率的差异.

主要方法:

在主要数据库 (PubMed,Embase,Cochrane,Scopus,CINAHL) 进行系统的文献搜索,直到2023年8月.
使用随机效应模型对11项研究 (1013名参与者) 的元分析.
评估结果,包括复发,块切除,R0切除,穿孔,手术长度和住院时间.

主要成果:

在ESD和TES之间的复发率 (OR:0.545,95%CI:0.176-1.687),块切除,R0切除或穿孔率方面没有发现显著差异.
程序长度显示,非显著的平均差异为-4.19分钟 (95%CI: -22.73至14.35).
对于ESD,住院时间略短,约为0.789天 (95%CI:-1.671至0.093).

结论:

在内镜下粘膜剖析中,ESD和TES的疗效和安全性相似.
在ESD和TES之间的选择可以根据个体患者的特征,外科医生的专业知识和临床背景进行指导.

关键词:

内镜下粘膜切割进行内镜下粘膜切割.进行元分析分析.这是直肠瘤.外科手术的结果通过门进行内镜下膜剖析.

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