Saurabh Chandan, Smit Deliwala, Shahab R Khan, Babu P Mohan, Banreet S Dhindsa, Jay Bapaye, Hemant Goyal, Lena L Kassab, Faisal Kamal, Harlan R Sayles, Gursimran S Kochhar, Douglas G Adler
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引用次数: 7
摘要
近年来,特别是随着新针头设计的出现,eus引导肝活检(EUS-LB)获得了发展势头。鉴于新出现的EUS-LB与第二代针头和经皮LB (PC-LB)的比较数据,我们进行了系统回顾和荟萃分析,比较了两种技术的安全性和有效性。我们检索了从成立到2021年11月的多个数据库,以确定比较EUS-LB和PC-LB结果的研究。使用随机效应模型计算合并估计,结果以合并比例和优势比(OR)以及相关的95%置信区间(ci)表示。最终分析纳入了5项研究,共748例患者。276例患者行EUS-LB, 472例患者行PC-LB。在所有研究中,PC-LB的总体诊断准确率高于EUS-LB,置信区间为98.6% (CI: 94.7-99.7)对88.3% (49.6-98.3),OR: 1.65, P = 0.04。在评估随机对照试验的数据时,两者之间没有差异。虽然PC-LB和EUS-LB的诊断充分性和总体不良事件没有显著差异,但前者在完全门静脉束(CPT)的平均数量和总标本长度方面优于后者。PC-LB和EUS-LB产生相似的结果。PC-LB允许获得更长的样品和更多的CPT。随着越来越多的供应商开始实施EUS-LB,这些趋势是否会持续下去,还需要进一步的研究。
EUS-guided versus percutaneous liver biopsy: A comprehensive review and meta-analysis of outcomes.
EUS-guided liver biopsy (EUS-LB) has gained momentum in recent years, especially with availability of newer needle designs. Given the emerging comparative data on EUS-LB with second-generation needles and percutaneous LB (PC-LB), we conducted a systematic review and meta-analysis to compare the safety and efficacy of the two techniques. We searched multiple databases from inception through November 2021 to identify studies comparing outcomes of EUS-LB and PC-LB. Pooled estimates were calculated using a random-effects model, and the results were expressed in terms of pooled proportions and odds ratio (OR) along with relevant 95% confidence intervals (CIs). Five studies with 748 patients were included in the final analysis. EUS-LB was performed in 276 patients and PC-LB in 472 patients. Across all studies, PC-LB had an overall higher diagnostic accuracy than EUS-LB, 98.6% confidence interval (CI: 94.7-99.7) versus 88.3% (49.6-98.3), OR: 1.65, P = 0.04. On assessing data from randomized controlled trials, there was no difference between the two. While pooled diagnostic adequacy and overall adverse events were not significantly different between PC-LB and EUS-LB, the former was superior in terms of the mean number of complete portal tracts (CPT) and total specimen length. PC-LB and EUS-LB produce similar results. PC-LB allows obtaining longer samples and more CPT. Further studies are needed to see if these trends hold up as more providers begin to perform EUS-LB.
期刊介绍:
Endoscopic Ultrasound, a publication of Euro-EUS Scientific Committee, Asia-Pacific EUS Task Force and Latin American Chapter of EUS, is a peer-reviewed online journal with Quarterly print on demand compilation of issues published. The journal’s full text is available online at http://www.eusjournal.com. The journal allows free access (Open Access) to its contents and permits authors to self-archive final accepted version of the articles on any OAI-compliant institutional / subject-based repository. The journal does not charge for submission, processing or publication of manuscripts and even for color reproduction of photographs.