结合内镜粘膜切除和全厚切除大结直肠息肉:一个系统的审查和元分析
Butros Fakhoury1, Iyiad Alabdul Razzak1, Rebecca Morin2
1St. Elizabeth's Medical Center, Boston, MA, USA.
Scandinavian journal of gastroenterology
|May 7, 2024
概括
结合内镜粘膜切除 (EMR) 和内镜全厚切除 (EFTR) 有效切除大结直肠多. 这种混合技术为高风险患者提供了一个安全的替代方案,具有高成功率和低不良事件率.
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:
- 大型结直肠多 (>2厘米) 造成切除的挑战.
- 结合内镜粘膜切除 (EMR) 与内镜全厚切除 (EFTR) 是针对大结直肠病变的新兴技术.
研究的目的:
- 系统地审查和元分析结合EMR与EFTR用于大结直肠病变的疗效和安全性.
- 为了评估技术成功,完成切除率,不良事件和复发情况.
主要方法:
- 在2023年8月之前全面搜索电子数据库.
- 包括报告混合FTR (EMR + EFTR) 的研究.
- 随机效应模型进行元分析,以汇集结果.
主要成果:
- 分析了8个研究手臂,包括244名患者.
- 聚合的技术成功率:97%.
- 聚合的宏观完全切除率:95%.
- 自由垂直边缘切除率:88%.
- 总体不良事件发生率:2%.
- 复发率: 6%. 这种疾病的复发率为6%.
结论:
- 结合EMR与EFTR在大型复杂结直肠腺瘤中是有效和安全的.
- 这种技术是高手术风险患者的可行替代方案.
- 需要进一步对ESD和手术切除进行比较研究.
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