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在内镜粘膜切除后的热废除的有效性和安全性:系统性审查和网络元分析

Hossein Haghbin¹, Nuruddinkhodja Zakirkhodjaev², Rawish Fatima³

¹Division of Gastroenterology, Ascension Providence Hospital, Southfield, MI 48075, USA.

Journal of clinical medicine

|April 9, 2024

概括

热废除方法如血凝血 (APC) 和陷尖软凝血 (STSC) 有效地减少内镜粘膜切除 (EMR) 后大结肠息肉的复发. 这两种方法的安全性与安慰剂可比,STSC显示的复发率最低.

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:

大型结肠多通常通过内镜粘膜切除 (EMR) 进行管理.
在EMR后复发的息肉是一种临床挑战.
已经引入了热废除技术,包括阿贡等离子凝固 (APC) 和蛇尖软凝固 (STSC),以减轻复发.

研究的目的:

进行一个网络元分析,比较APC和STSC在大结肠息肉管理中的有效性和安全性.
评估EMR后与这些热废除方式相关的复发率和不良事件.

主要方法:

在多个数据库中进行了全面的文献搜索,截至2024年1月5日.
使用随机效应模型进行了一个频率网络元分析.
为有效性和安全性终点计算了95%置信区间 (CI) 的风险比率 (RR).

主要成果:

该分析包括了13项研究,涉及2686名患者.
与安慰剂相比,APC (RR:0.33) 和STSC (RR:0.27) 均显著降低了聚复发的发生率 (p < 0.01).
STSC显示出最低的复发率,其次是APC;在方法和安慰剂之间没有观察到不良事件 (出血,穿孔,后多角切除综合征) 的显著差异.

结论:

热除,特别是APC和STSC,有效地减少EMR后腺瘤复发.
这些热除方法可以安全地与EMR一起用于大结肠多.
STSC似乎是最有效的热除方法,以防止多的复发.

关键词:

的血凝固是的血凝固.结肠镜检查结肠镜检查进行内镜粘膜切除.陷的尖端软凝固软凝固

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