{"title":"内镜下粘膜切除与内镜下粘膜剥离治疗≤10mm直肠神经内分泌肿瘤的疗效:系统综述和meta分析。","authors":"Ce Zhou, Furong Zhang, Yinghua We","doi":"10.5144/0256-4947.2023.179","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD) are surgical methods used for rectal neuroendocrine tumors (NETs) with diameters of ≤ 10 mm. However, which method has a higher performance remains uncertain.</p><p><strong>Objectives: </strong>Evaluate which of the two methods shows a higher performance.</p><p><strong>Design: </strong>Systematic review and meta-analysis METHODS: Data from PubMed, Embase, Cochrane Library, and Web of Science were searched from inception to 12 April 2022. Outcomes, including complete resection, en bloc resection, recurrence, perforation, bleeding, and procedure time, were pooled by 95% confidence intervals (95% CI) using a fixed- or random-effects model.</p><p><strong>Main outcome measures: </strong>Complete resection, en bloc resection, and recurrence.</p><p><strong>Sample size: </strong>18 studies, including 1168 patients were included in the study.</p><p><strong>Results: </strong>Eighteen retrospective cohort studies were included in this meta-analysis. There were no statistical differences in the rates of complete resection, en bloc resection, recurrence, perforation, and bleeding rates between EMR and ESD. However, a statistical difference was detected in the procedure time; EMR had a significantly shorter time (MD=-17.47, 95% CI=-22.31 - -12.62, <i>P</i><.00001).</p><p><strong>Conclusions: </strong>EMR and ESD had similar efficacies and safety profiles in resectioning rectal NETs ≤ 10 mm. Even so, the advantages of EMR included a shorter operation time and expenditure. Thus, with respect to health economics, EMR outperformed ESD.</p><p><strong>Limitation: </strong>Most of these studies are retrospective cohort studies instead of RCTs.</p><p><strong>Conflict of interest: </strong>None.</p>","PeriodicalId":8016,"journal":{"name":"Annals of Saudi Medicine","volume":"43 3","pages":"179-195"},"PeriodicalIF":1.5000,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/bd/38/0256-4947.2023.179.PMC10317491.pdf","citationCount":"0","resultStr":"{\"title\":\"Efficacy of endoscopic mucosal resection versus endoscopic submucosal dissection for rectal neuroendocrine tumors ≤10mm: a systematic review and meta-analysis.\",\"authors\":\"Ce Zhou, Furong Zhang, Yinghua We\",\"doi\":\"10.5144/0256-4947.2023.179\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD) are surgical methods used for rectal neuroendocrine tumors (NETs) with diameters of ≤ 10 mm. However, which method has a higher performance remains uncertain.</p><p><strong>Objectives: </strong>Evaluate which of the two methods shows a higher performance.</p><p><strong>Design: </strong>Systematic review and meta-analysis METHODS: Data from PubMed, Embase, Cochrane Library, and Web of Science were searched from inception to 12 April 2022. Outcomes, including complete resection, en bloc resection, recurrence, perforation, bleeding, and procedure time, were pooled by 95% confidence intervals (95% CI) using a fixed- or random-effects model.</p><p><strong>Main outcome measures: </strong>Complete resection, en bloc resection, and recurrence.</p><p><strong>Sample size: </strong>18 studies, including 1168 patients were included in the study.</p><p><strong>Results: </strong>Eighteen retrospective cohort studies were included in this meta-analysis. There were no statistical differences in the rates of complete resection, en bloc resection, recurrence, perforation, and bleeding rates between EMR and ESD. However, a statistical difference was detected in the procedure time; EMR had a significantly shorter time (MD=-17.47, 95% CI=-22.31 - -12.62, <i>P</i><.00001).</p><p><strong>Conclusions: </strong>EMR and ESD had similar efficacies and safety profiles in resectioning rectal NETs ≤ 10 mm. Even so, the advantages of EMR included a shorter operation time and expenditure. Thus, with respect to health economics, EMR outperformed ESD.</p><p><strong>Limitation: </strong>Most of these studies are retrospective cohort studies instead of RCTs.</p><p><strong>Conflict of interest: </strong>None.</p>\",\"PeriodicalId\":8016,\"journal\":{\"name\":\"Annals of Saudi Medicine\",\"volume\":\"43 3\",\"pages\":\"179-195\"},\"PeriodicalIF\":1.5000,\"publicationDate\":\"2023-05-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/bd/38/0256-4947.2023.179.PMC10317491.pdf\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Annals of Saudi Medicine\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.5144/0256-4947.2023.179\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"MEDICINE, GENERAL & INTERNAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Annals of Saudi Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.5144/0256-4947.2023.179","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
引用次数: 0
摘要
背景:内镜下粘膜切除(EMR)和内镜下粘膜剥离(ESD)是治疗直径≤10 mm的直肠神经内分泌肿瘤(NETs)的手术方法。然而，哪种方法具有更高的性能仍然是不确定的。目的:评价两种方法中哪一种表现更好。方法:检索PubMed、Embase、Cochrane Library和Web of Science自成立至2022年4月12日的数据。结果包括完全切除、整体切除、复发、穿孔、出血和手术时间，采用固定效应或随机效应模型，以95%置信区间(95% CI)汇总。主要观察指标:完全切除、整体切除和复发。样本量:共纳入18项研究，1168例患者。结果:本荟萃分析纳入了18项回顾性队列研究。EMR和ESD在全切率、全切率、复发率、穿孔率和出血率方面无统计学差异。但在处理时间上存在统计学差异;结论:EMR和ESD在切除≤10 mm的直肠NETs时具有相似的疗效和安全性。尽管如此，EMR的优势包括更短的操作时间和费用。因此，在卫生经济学方面，电子病历优于可持续发展教育。局限性:这些研究大多是回顾性队列研究，而不是随机对照试验。利益冲突:无。
Efficacy of endoscopic mucosal resection versus endoscopic submucosal dissection for rectal neuroendocrine tumors ≤10mm: a systematic review and meta-analysis.
Background: Endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD) are surgical methods used for rectal neuroendocrine tumors (NETs) with diameters of ≤ 10 mm. However, which method has a higher performance remains uncertain.
Objectives: Evaluate which of the two methods shows a higher performance.
Design: Systematic review and meta-analysis METHODS: Data from PubMed, Embase, Cochrane Library, and Web of Science were searched from inception to 12 April 2022. Outcomes, including complete resection, en bloc resection, recurrence, perforation, bleeding, and procedure time, were pooled by 95% confidence intervals (95% CI) using a fixed- or random-effects model.
Main outcome measures: Complete resection, en bloc resection, and recurrence.
Sample size: 18 studies, including 1168 patients were included in the study.
Results: Eighteen retrospective cohort studies were included in this meta-analysis. There were no statistical differences in the rates of complete resection, en bloc resection, recurrence, perforation, and bleeding rates between EMR and ESD. However, a statistical difference was detected in the procedure time; EMR had a significantly shorter time (MD=-17.47, 95% CI=-22.31 - -12.62, P<.00001).
Conclusions: EMR and ESD had similar efficacies and safety profiles in resectioning rectal NETs ≤ 10 mm. Even so, the advantages of EMR included a shorter operation time and expenditure. Thus, with respect to health economics, EMR outperformed ESD.
Limitation: Most of these studies are retrospective cohort studies instead of RCTs.
期刊介绍：
The Annals of Saudi Medicine (ASM) is published bimonthly by King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia. We publish scientific reports of clinical interest in English. All submissions are subject to peer review by the editorial board and by reviewers in appropriate specialties. The journal will consider for publication manuscripts from any part of the world, but particularly reports that would be of interest to readers in the Middle East or other parts of Asia and Africa. Please go to the Author Resource Center for additional information.
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