Kengo Hayashi, Saki Hayashi, Roberto Passera, Chiara Meroni, Rebecca Dallorto, Chiara Marafante, Carlo Alberto Ammirati, Alberto Arezzo, Noriyuki Inaki
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LR showed a higher complete resection rate (RR 0.98, 95% CI 0.97–0.99, <i>p</i> < 0.01). eER favored operative time (95% CI -57.66 to −23.71, <i>p</i> < 0.01), blood loss (95% CI -63.46 to −17.45, <i>p</i> < 0.01), time to oral intake (95% CI -1.64 to −0.33, <i>p</i> < 0.01), and hospital stay (95% CI -1.75 to −0.13, <i>p</i> = 0.023). Subgroup analysis comparing endoscopic full-thickness resection (EFTR) to LR showed no significant difference in complete resection (RR 0.98, 95% CI 0.95–1.01, <i>p</i> = 0.18).</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>LR may offer a higher complete resection rate, but eER demonstrated better short-term outcomes. 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引用次数: 0
摘要
胃粘膜下肿瘤（G-SMTs）的恶性风险各不相同，手术切除是标准治疗方法。虽然扩大内镜切除（eER）提供了一种侵入性较小的选择，但相对于腹腔镜切除（LR），其结果尚不清楚。本研究评价了eER和LR的安全性和有效性。材料和方法一项系统综述和荟萃分析包括了比较g - smt的eER和LR的文章。主要结果是完全切除率。结果纳入17项研究，包括1262例eER和990例LR患者。LR显示更高的完全切除率（RR 0.98, 95% CI 0.97-0.99, p < 0.01）。eER倾向于手术时间（95% CI -57.66 ~ - 23.71, p < 0.01）、出血量（95% CI -63.46 ~ - 17.45, p < 0.01）、口服时间（95% CI -1.64 ~ - 0.33, p < 0.01）和住院时间（95% CI -1.75 ~ - 0.13, p = 0.023）。亚组分析结果显示，内镜下全层切除术（EFTR）与LR在完全切除方面无显著差异（RR 0.98, 95% CI 0.95 ~ 1.01, p = 0.18）。结论LR可能提供更高的完全切除率，但eER表现出更好的短期预后。EFTR实现了与LR相当的切除率，通过进一步的技术改进支持更广泛的采用。
Endoscopic Resection Versus Laparoscopic Resection for Gastric Submucosal Tumors: A Systematic Review and Meta-Analysis of Safety and Efficacy
Introduction
Gastric submucosal tumors (G-SMTs) vary in malignancy risk, with surgical resection as standard treatment. Although extended endoscopic resection (eER) offers a less invasive option, its outcomes relative to laparoscopic resection (LR) remain unclear. This study evaluates the safety and efficacy of eER and LR.
Materials and Methods
A systematic review and meta-analysis included articles comparing eER and LR for G-SMTs. The primary outcome was a complete resection rate.
Results
17 studies involving 1262 eER and 990 LR patients were included. LR showed a higher complete resection rate (RR 0.98, 95% CI 0.97–0.99, p < 0.01). eER favored operative time (95% CI -57.66 to −23.71, p < 0.01), blood loss (95% CI -63.46 to −17.45, p < 0.01), time to oral intake (95% CI -1.64 to −0.33, p < 0.01), and hospital stay (95% CI -1.75 to −0.13, p = 0.023). Subgroup analysis comparing endoscopic full-thickness resection (EFTR) to LR showed no significant difference in complete resection (RR 0.98, 95% CI 0.95–1.01, p = 0.18).
Conclusions
LR may offer a higher complete resection rate, but eER demonstrated better short-term outcomes. EFTR achieved comparable resection rates to LR, supporting broader adoption with further technical refinement.
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