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首页> 外文期刊>Surgical Endoscopy >Efficacy and safety of endoscopic full-thickness resection in the colon and rectum using an over-the-scope device: a meta-analysis
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Efficacy and safety of endoscopic full-thickness resection in the colon and rectum using an over-the-scope device: a meta-analysis

机译：使用过度范围装置的结肠和直肠内镜全厚切除的疗效和安全性：META分析

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Objective Relevant publications were identified by searching PubMed, EMBASE, Cochrane Central Register of Controlled Trials and Web of Science before December 1, 2019. Studies in which >= 10 cases of colorectal lesions were resected with endoscopic full-thickness resection (EFTR) were included. Rates of efficacy (technical success (en bloc), full-thickness resection and R0 resection), rates of safety (bleeding, perforation and postpolypectomy syndrome) and rates of follow-up (residual/recurrent adenoma, fate of over-the-scope clip and surgery for any reason) were pooled and analyzed. Forest plots were graphed based on random effects models. Subgroup analyses and sensitivity analyses were also performed if significant heterogeneity existed. Results A total of 469 patients across 9 studies were eligible for analysis. The pooled rates of technical success, full-thickness resection and R0 resection were 94.0% (95% CI 89.8-97.3%), 89.5% (83.9-94.2%) and 84.9% (75.1-92.8%), respectively. The pooled estimates of bleeding, perforation and postpolypectomy syndrome were 2.2% (95% CI 0.4-4.9%), 0.19% (95% CI 0.00-1.25%) and 2.3% (95% CI 0.1-6.3%), respectively. Finally, the pooled rates of residual/recurrent adenoma, fate of OTSC and surgery for any reason were 8.5% (95% CI 4.1-14.0%), 80.3% (95% CI 67.5-90.8%) and 6.3% (2.4-11.7%), respectively. Conclusions EFTR for nonlifting, invasive lesions in the colon and rectum appears to be effective and safe. However, future studies are necessary to explore the role of EFTR in large colorectal lesions and specify its indications.
机译：目的通过在2019年12月1日前搜索PubMed、EMBASE、Cochrane中央对照试验登记册和科学网，确定相关出版物。其中包括10例以上的大肠病变采用内镜全层切除术（EFTR）切除的研究。收集并分析了有效率（技术成功率（整体）、全层切除率和R0切除率）、安全率（出血、穿孔和息肉切除后综合征）和随访率（残留/复发腺瘤、超范围夹的命运和任何原因的手术）。根据随机效应模型绘制森林图。如果存在显著的异质性，也进行亚组分析和敏感性分析。结果共有9项研究中的469名患者符合分析条件。技术成功率、全层切除率和R0切除率分别为94.0%（95%可信区间89.8-97.3%）、89.5%（83.9-94.2%）和84.9%（75.1-92.8%）。出血、穿孔和胆囊切除术后综合征的合并估计值分别为2.2%（95%可信区间0.4-4.9%）、0.19%（95%可信区间0.00-1.25%）和2.3%（95%可信区间0.1-6.3%）。最后，残留/复发腺瘤、OTSC命运和任何原因手术的合并率分别为8.5%（95%可信区间4.1-14.0%）、80.3%（95%可信区间67.5-90.8%）和6.3%（2.4-11.7%）。结论EFTR治疗结肠和直肠非提升性浸润性病变是有效和安全的。然而，未来的研究有必要探索EFTR在大肠大病变中的作用，并明确其适应症。

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