恶性胃出口阻塞的息程序:一个网络元分析
Khoi Van Tran1,2, Nguyen-Phong Vo3, Hung Song Nguyen4,5
1International PhD Program in Medicine, College of Medicine, Taipei Medical University, Taipei City, Taiwan.
Endoscopy
|April 19, 2024
概括
对于恶性胃出口阻塞 (GOO),建议进行胃分区胃肠肠静脉切除术 (PGJ) 和内超声导向胃肠静脉切除术 (EUS-GE). 在临床成功和再干预率方面,PGJ提供了优势,而EUS-GE在降低死亡率和并发症方面表现出色.
科学领域:
- 胃肠病学 胃肠病学
- 手术瘤学手术瘤学
- 干预性内镜检查是干预性的内镜检查.
背景情况:
- 对于恶性胃出口阻塞 (GOO) 的最佳息治疗尚未确定.
- 本综述侧重于比较消化器内科医生,内镜超声导向消化器内科医生 (EUS-GE),胃分区消化器内科医生 (PGJ) 和对恶性GOO进行内镜支架.
研究的目的:
- 系统地审查和比较四种息治疗恶性GOO的疗效和安全性.
- 根据临床成功,死亡率,再干预和并发症率来确定最佳的治疗策略.
主要方法:
- 对多个数据库 (PubMed,Embase,Cochrane,Scopus,Web of Science) 和临床试验注册表进行了系统的搜索.
- 包括随机对照试验 (RCT) 和报告关键临床结果的队列研究.
- 使用频率主义方法与逆方差建模的网络元分析进行,以根据P-score对治疗进行排名.
主要成果:
- 该分析包括39项研究中的3617名患者 (4项RCT,4项前性,32项后性).
- 胃分区胃肠 (PGJ) 显示出更高的临床成功率和更低的再干预率 (P-score:0.95,0.90).
- 透视式超声导向胃肠静脉切除术 (EUS-GE) 显示了减少30天死亡率和并发症的最高概率 (P-score:0.82,0.99).
- 集群排名证实了PGJ和EUS-GE对死亡率和重新干预的好处.
结论:
- 建议PGJ和EUS-GE作为恶性GOO的有效息治疗方法.
- PGJ是一种可行的替代方案,特别是在资源有限的环境中或不适合EUS-GE的患者.
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