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一个网络对恶性胃出口阻塞的最佳治疗方法的元分析

Takashi Tamura¹, Ke Wan², Reiko Ashida³

¹Second Department of Internal Medicine, Wakayama Medical University, 811-1, Kimiidera, Wakayama City, Wakayama 641-8509, Japan.

Therapeutic advances in gastroenterology

|January 6, 2026

概括

内镜超声导向胃肠静脉切除术 (EUS-GE) 是对恶性胃出口阻塞 (GOO) 的最有效的治疗方法,比内镜支架 (ES) 和外科胃肠静脉切除术 (SGJ) 具有更高的疗效和安全性. EUS-GE为GOO管理提供了更好的长期成果.

科学领域:

胃肠病学胃肠病学
干预性内镜检查是干预性的内镜检查.
手术瘤学手术瘤学

背景情况:

恶性胃出口阻塞 (GOO) 严重影响患者的生活质量.
目前的息治疗包括手术性胃口干肠术 (SGJ),内镜支架 (ES) 和内镜超声波导向胃口干肠术 (EUS-GE).
最佳治疗选择受到研究结果的变化和有限的比较数据的阻碍.

研究的目的:

为了比较EUS-GE,ES和SGJ的有效性和安全性,用于管理恶性GOO.
确定GOO最佳的息治疗策略.

主要方法:

在PubMed,Cochrane图书馆和Web of Science的系统文献搜索随机对照试验和队列研究.
54项涉及6110名患者的研究的网络元分析 (SGJ: 1974,ES: 3226,EUS-GE: 910).
主要结果:对于反复出现的国有政府部门的再干预率. 二次结果:临床成功率和不良事件率.

主要成果:

与ES相比,SGJ和EUS-GE都显著降低了再干预率.
与ES相比,EUS-GE的临床成功率高于ES.
EUS-GE的不良事件发生率低于SGJ和ES.
检测到适度的异质性和没有显著的出版偏差.

结论:

在有效性,安全性和耐久性方面,EUS-GE为GOO管理提供了最有利的概况.
SGJ仍然是一个可行的选择,特别是在先进内镜专业知识有限的地方.
这些发现支持EUS-GE的更广泛采用,并可能为GOO治疗提供临床指南.

关键词:

通过内镜进行支架.通过内镜超声波引导的胃肠静脉修复术.胃出道阻塞胃出道阻塞通过皮肤排水.手术性胃肠结节术 (Gastrojejunostomy) 是一种手术.

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