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用于治疗直肠瘤的内镜切除和门外科手术之间的比较:系统性审查和元分析

Chan Hyuk Park¹, Byung Wook Jung^2,3, Yoon Suk Jung⁴

¹Department of Internal Medicine, Chung-Ang University Health Care System Hyundae Hospital, Namyangju, Korea.

Intestinal research

|December 5, 2025

概括

内镜切除 (ER) 和过门手术 (TAS) 为早期直肠瘤提供器官保存. 对于腺瘤/腺癌,ER和TAS显示了类似的结果,但TAS为神经内分泌瘤 (NET) 提供了更好的R0切除率.

科学领域:

胃肠病学胃肠病学
手术瘤学手术瘤学
最少侵入性的手术

背景情况:

早期的直肠瘤可以通过保存器官的最小侵入性技术来治疗,例如内镜切除 (ER) 和过门手术 (TAS).
将ER与TAS的疗效和安全性进行比较对于优化治疗策略至关重要.

研究的目的:

进行一项元分析,比较ER和TAS之间的治疗结果,用于早期直肠瘤.
评估R0切除率,并发症率,额外手术和不同直肠瘤类型的复发率.

主要方法:

对2024年1月之前发表的研究进行了系统的文献搜索.
包括的研究比较了直肠腺瘤,腺癌和神经内分泌瘤 (NET) 的ER和TAS.
经过元分析,综合了17项涉及1569名患者的研究数据.

主要成果:

对于腺瘤/腺癌,R0切除率在ER和TAS之间是可比的 (RR,0.99;95% CI,0.94-1.03).
对于NET,TAS与ER相比显示出更高的R0切除率 (RR,0.76;95%CI,0.68-0.84),而ER的手术时间更短.
对于任何一种瘤类型,ER和TAS之间并发症率,需要额外的手术和复发并没有显著差异.

结论:

对于直肠腺瘤/腺癌,ER和TAS的结果相似,由于成本较低,ER可能会受到青.
TAS为直肠NET提供了更高的R0切除率,但涉及更长的程序时间和更高的成本.
对于疑似深层透的大型直肠NET,可以选择性地考虑TAS,以平衡有效性和资源利用.

关键词:

内镜切除术是一种内镜切除术.直肠神经内分泌瘤是直肠的神经内分泌瘤.这是直肠瘤.通过门进行手术.

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