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首页> 外文期刊>Surgical Endoscopy >Efficacy of endoscopic submucosal tunnel dissection versus endoscopic submucosal dissection for superficial esophageal neoplastic lesions: a systematic review and meta-analysis
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Efficacy of endoscopic submucosal tunnel dissection versus endoscopic submucosal dissection for superficial esophageal neoplastic lesions: a systematic review and meta-analysis

机译：内镜粘膜肿瘤扫描的功效浅表性食管肿瘤病变的内窥镜粘膜粘膜分析：系统评价和荟萃分析

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Background To evaluate the effectiveness of endoscopic submucosal tunnel dissection (ESTD) and endoscopic submucosal dissection (ESD) in superficial esophageal neoplastic lesions (SENL). Methods A comprehensive search for studies investigating the efficacy of ESTD and ESD for SENL was conducted to search for relevant studies through PubMed, Web of Science, Cochrane Library, SinoMed, CNKI, and Wanfang. Weighted pooled rates were calculated for en bloc resection rate, R0 resection rate, operation time, dissection area, dissection speed, and adverse events. The 95% confidence intervals (95%CI) for effect size were used to calculate the pooled value using the fixed- or random-effects model. Results A total of seventeen studies with 1161 patients were identified and included in the meta-analysis. The pooled analysis showed that ESTD had significantly higher en bloc resection (OR 3.98; 95% CI 1.74 to 9.12;p = 0.001) and R0 resection rates (OR 2.29; 95% CI 1.54 to 3.46;p < 0.001) than ESD. The operation time in the ESTD group was shorter than that in the ESD group (SMD = - 0.57; 95% CI - 0.95 to - 0.19;p = 0.003). The dissection area of the ESTD group was larger than that in the ESD group (SMD = 0.49; 95% CI 0.16 to 0.83;p = 0.004), and the dissection speed is faster than that in the ESD group (SMD = 1.52; 95%CI 1.09 to 0.83;p < 0.001). There were no significant differences in esophageal stenosis (p = 0.94) between the two techniques. However, ESTD was superior to ESD in other adverse events (p < 0.05). Conclusion ESTD has a significant advantage over ESD in the treatment of SENL. ESTD has significantly higher en bloc and R0 resection rates and reduced adverse events.
机译：背景：评估内镜黏膜下隧道剥离术（ESTD）和内镜黏膜下剥离术（ESD）治疗浅表性食管肿瘤性病变（SENL）的有效性。方法通过PubMed、Web of Science、Cochrane Library、SinoMed、CNKI和万方检索ESTD和ESD对SENL疗效的研究。计算整体切除率、R0切除率、手术时间、解剖面积、解剖速度和不良事件的加权合并率。效应大小的95%置信区间（95%CI）用于使用固定效应或随机效应模型计算合并值。结果共有17项研究涉及1161名患者，纳入荟萃分析。综合分析显示，ESTD的整体切除率（OR 3.98；95%可信区间1.74至9.12；p=0.001）和R0切除率（OR 2.29；95%可信区间1.54至3.46；p<0.001）明显高于ESD。ESTD组的手术时间比ESD组短（SMD=-0.57；95%可信区间-0.95至-0.19；p=0.003）。ESTD组的剥离面积大于ESD组（SMD=0.49；95%CI 0.16至0.83；p=0.004），剥离速度快于ESD组（SMD=1.52；95%CI 1.09至0.83；p<0.001）。两种技术在食管狭窄方面没有显著差异（p=0.94）。然而，ESTD在其他不良事件方面优于ESD（p<0.05）。结论ESTD治疗SENL优于ESD。ESTD整体切除率和R0切除率显著提高，不良事件减少。

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