Jae Gon Lee, Jin Hwa Park, Sang Pyo Lee, Kang Nyeong Lee
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引用次数: 0
摘要
背景:内镜切除(ER)被认为是治疗胃腺瘤的首选方法。氩等离子体凝固(APC)也被广泛应用,但其有效性和安全性尚未完全确定。我们进行了一项系统回顾和荟萃分析,以评估APC与ER治疗胃腺瘤的疗效和安全性。方法:检索截至2024年4月的PubMed、EMBASE和Cochrane Library。所有评估APC或ER治疗胃腺瘤临床结果的研究均被纳入。主要结果是APC与ER的局部复发率。次要结局包括手术时间、住院时间和并发症。结果:共纳入7项研究,其中4项为回顾性研究,比较APC和ER的结果,3项为回顾性单臂研究,仅报道APC的结果。APC治疗胃腺瘤的局部复发率高于ER[风险比(RR) 4.378, 95% CI 1.995-9.607],但手术时间较短(MD -45.228, 95% CI -49.436至-41.021),住院时间较短(MD -2.684, 95% CI -2.932至-2.437),并发症较少(RR 0.329, 95% CI 0.124-0.869)。结论:APC的局部复发率高于ER,但并发症发生率低于ER。APC可能被认为是治疗胃腺瘤的替代ER。
Argon plasma coagulation versus endoscopic resection for the treatment of gastric adenomas: A systematic review and meta-analysis.
Background: Endoscopic resection (ER) is regarded as the treatment of choice for gastric adenoma. Argon plasma coagulation (APC) is also widely used, but its efficacy and safety have not been fully established. We performed a systematic review and meta-analysis to assess the efficacy and safety of APC compared with ER in treating gastric adenoma.
Methods: PubMed, EMBASE, and the Cochrane Library were searched up to April 2024. All studies that evaluated the clinical outcomes of APC or ER for treating gastric adenomas were included. The primary outcome was the local recurrence rates of APC versus ER. Secondary outcomes included procedure time, length of hospital stay, and complications.
Results: A total of seven studies were included, of which four were retrospective studies that compared the outcomes of APC and ER, and three were retrospective single-arm studies that reported only outcomes of APC. APC was associated with a higher local recurrence rate in treating gastric adenoma than ER [risk ratio (RR) 4.378, 95% CI 1.995-9.607] but involved shorter procedure times (MD -45.228, 95% CI -49.436 to -41.021), shorter hospital stays (MD -2.684, 95% CI -2.932 to -2.437), and fewer complications (RR 0.329, 95% CI 0.124-0.869).
Conclusions: APC results in more local recurrence but involved a lower risk of complications than ER. APC may be considered an alternative to ER in treating gastric adenomas.
期刊介绍:
The Saudi Journal of Gastroenterology (SJG) is an open access peer-reviewed publication. Authors are invited to submit articles in the field of gastroenterology, hepatology and nutrition, with a wide spectrum of coverage including basic science, epidemiology, diagnostics, therapeutics, public health, and standards of health care in relation to the concerned specialty. Review articles are usually by invitation. However review articles of current interest and a high standard of scientific value could also be considered for publication.