结直肠多瘤冷陷多斑切除术和内镜粘膜切除术的比较元分析:评估疗效和安全性
Shouqi Wang1, Qi Zhang1,2, Li Rong Meng2
1The Second Affiliated Hospital, Soochow University, Soochow, China.
PeerJ
|December 23, 2024
概括
冷陷多角切除术 (CSP) 和内镜粘膜切除术 (EMR) 是常见的结肠直肠多治疗方法. 这项元分析发现,CSP的完整切除率较低,但出血延迟也比EMR少,这表明技术选择取决于患者和息肉因素.
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:
- 结肠直肠多需要内镜去除,冷陷多镜切除 (CSP) 和内镜粘膜切除 (EMR) 是主要的方法.
- 对于临床决策至关重要的是对CSP与EMR在结直肠聚管理中的疗效和安全性的比较数据.
研究的目的:
- 进行一项元分析,比较冷陷多角切除术 (CSP) 和内镜粘膜切除术 (EMR) 对结肠直肠多的疗效和安全性.
- 评估结果,包括完整切除率,块切除,出血,穿孔和手术时间.
主要方法:
- 在主要数据库 (PubMed,Embase,CINAHL,Web of Science,Cochrane Library) 进行系统的文献搜索,截至2024年6月.
- 六项研究的元分析,包括15296名患者和17971名多体.
- 使用Mantle-Haenszel和逆方差方法进行统计分析;执行子组分析.
主要成果:
- 与内镜粘膜切除 (EMR) 相比,冷陷多重切除术 (CSP) 的完全切除率明显较低 (OR:0.44,p=0.0334).
- 在块式切除率,穿孔或手术时间方面,CSP和EMR之间没有发现显著差异.
- 与EMR相比,CSP与延迟出血率明显较低 (OR:0.45,p=0.0034),在立即出血方面没有差异.
结论:
- 冷陷多角切除术 (CSP) 是一种安全有效的内镜技术,用于结直肠多,与内镜粘膜切除术 (EMR) 相似.
- 虽然CSP显示较低的完全切除率,但它的优势在于减少延迟出血.
- 在CSP和EMR之间进行选择应根据患者和聚的特征进行个性化选择.
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