腹膜病变的内镜治疗与手术治疗:通过元分析进行系统性审查
Luiza Martins Baroni1, Mateus Pereira Funari2, Angelo So Taa Kum3
1Gastroenterology, Hospital das Clínicas de São Paulo, São Paulo, BRA.
Cureus
|August 22, 2024
概括
外科手术方法提供更高的完全切除率为膜病变,但涉及更多的不良事件和较长的住院时间比内镜方法. 内镜治疗可能导致不完全切除和更高的复发率.
科学领域:
- 胃肠道学和外科瘤学
背景情况:
- 脉冲性病变 (ALs) 存在治疗挑战,内镜 (EA) 和手术 (SA) 方法具有不同的风险概况.
- EA有不完全切除的风险,而SA可能导致显著的发病率.
研究的目的:
- 系统地审查和比较SA和EA之间的R0切除,复发,不良事件和ALS的住院时间.
主要方法:
- 从研究开始到2023年发表的研究的系统审查和元分析.
- 分析中包括了9项独立研究.
主要成果:
- 在SA中,R0切除率显著提高 (风险差异为-0.32) 和复发率降低 (风险差异为0.12).
- EA与较少的整体不良事件 (风险差异-0.22) 和较短的住院时间 (风险差异-14.69天) 相关.
- 两种方法之间在重大并发症或死亡率方面没有发现显著差异.
结论:
- 手术方法为囊性病变提供了优越的瘤结果 (完全切除,较低的复发率).
- 内镜方法提供了一个潜在的更安全的替代方案,降低了发病率和更短的住院时间,尽管不完全切除的风险更高.
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