{"title":"单纯性肝囊肿经皮穿刺和硬化治疗：一项系统回顾和荟萃分析。","authors":"Tomohiro Matsumoto, Rika Yoshimatsu, Marina Osaki, Junki Shibata, Kana Miyatake, Tomoaki Yamanishi, Takuji Yamagami","doi":"10.1007/s11604-025-01874-7","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>This systematic review aims to assess the efficacy and safety of percutaneous aspiration and sclerotherapy (PAS) for patients with symptomatic simple hepatic cysts (SHCs).</p><p><strong>Materials and methods: </strong>We systematically searched the electronic databases of PubMed, Embase, the Cochrane Library and Ichushi-Web for studies published up to November 2024, reporting outcomes of PAS for symptomatic SHCs. The primary outcomes were rates of symptomatic relief or disappearance of symptoms. The secondary outcomes were cyst volume reduction rates and complication rates. Subgroup analyses compared ethanol with the other sclerosants. Single-arm meta-analyses were performed, with meta-regression conducted when substantial heterogeneity (I<sup>2</sup> > 50%) was observed. Risk of bias was assessed using the Cochrane RoB2 tool for randomized controlled trials and RoBANS2 for non-randomized studies.</p><p><strong>Results: </strong>Sixteen studies were included. Fourteen studies were assessed as having a high risk of bias. The pooled symptomatic relief or disappearance rate was 86.9% (95% CI 80.2-91.6%, I<sup>2</sup> = 0%). The cyst volume reduction rate was 86.4% (95% CI 74.1-93.3%, I<sup>2</sup> = 95%). There were no major complications. The pooled minor complication rates were 13.6% (95% CI 6.5-26.4%, I<sup>2</sup> = 67.2%) for pain and 7.4% (95% CI 4.1-13.0%, I<sup>2</sup> = 38%) for fever. Subgroup analysis showed no significant differences between ethanol and other sclerosants. High heterogeneity was observed for cyst volume reduction and pain, indicating variability across studies. Meta-regression analysis for cyst volume reduction rate and pain did not identify any significant associations.</p><p><strong>Conclusion: </strong>PAS appears to be a relatively safe and effective treatment option for patients with symptomatic SHCs and provides high rates of symptomatic relief with low complication rates. However, given the high risk of bias in the available evidence and the lack of direct comparison with surgical treatment, these findings should be interpreted with caution. Further high-quality comparative studies are warranted to confirm these results.</p>","PeriodicalId":14691,"journal":{"name":"Japanese Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":2.1000,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Percutaneous aspiration and sclerotherapy for simple hepatic cysts: a systematic review and meta-analysis.\",\"authors\":\"Tomohiro Matsumoto, Rika Yoshimatsu, Marina Osaki, Junki Shibata, Kana Miyatake, Tomoaki Yamanishi, Takuji Yamagami\",\"doi\":\"10.1007/s11604-025-01874-7\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>This systematic review aims to assess the efficacy and safety of percutaneous aspiration and sclerotherapy (PAS) for patients with symptomatic simple hepatic cysts (SHCs).</p><p><strong>Materials and methods: </strong>We systematically searched the electronic databases of PubMed, Embase, the Cochrane Library and Ichushi-Web for studies published up to November 2024, reporting outcomes of PAS for symptomatic SHCs. The primary outcomes were rates of symptomatic relief or disappearance of symptoms. The secondary outcomes were cyst volume reduction rates and complication rates. Subgroup analyses compared ethanol with the other sclerosants. Single-arm meta-analyses were performed, with meta-regression conducted when substantial heterogeneity (I<sup>2</sup> > 50%) was observed. Risk of bias was assessed using the Cochrane RoB2 tool for randomized controlled trials and RoBANS2 for non-randomized studies.</p><p><strong>Results: </strong>Sixteen studies were included. Fourteen studies were assessed as having a high risk of bias. The pooled symptomatic relief or disappearance rate was 86.9% (95% CI 80.2-91.6%, I<sup>2</sup> = 0%). The cyst volume reduction rate was 86.4% (95% CI 74.1-93.3%, I<sup>2</sup> = 95%). There were no major complications. The pooled minor complication rates were 13.6% (95% CI 6.5-26.4%, I<sup>2</sup> = 67.2%) for pain and 7.4% (95% CI 4.1-13.0%, I<sup>2</sup> = 38%) for fever. Subgroup analysis showed no significant differences between ethanol and other sclerosants. High heterogeneity was observed for cyst volume reduction and pain, indicating variability across studies. Meta-regression analysis for cyst volume reduction rate and pain did not identify any significant associations.</p><p><strong>Conclusion: </strong>PAS appears to be a relatively safe and effective treatment option for patients with symptomatic SHCs and provides high rates of symptomatic relief with low complication rates. However, given the high risk of bias in the available evidence and the lack of direct comparison with surgical treatment, these findings should be interpreted with caution. Further high-quality comparative studies are warranted to confirm these results.</p>\",\"PeriodicalId\":14691,\"journal\":{\"name\":\"Japanese Journal of Radiology\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":2.1000,\"publicationDate\":\"2025-09-30\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Japanese Journal of Radiology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s11604-025-01874-7\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Japanese Journal of Radiology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s11604-025-01874-7","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
摘要
目的：本系统综述旨在评估经皮穿刺硬化疗法（PAS）治疗有症状的单纯性肝囊肿（SHCs）的疗效和安全性。材料和方法：我们系统地检索PubMed、Embase、Cochrane Library和Ichushi-Web的电子数据库，检索截至2024年11月发表的研究，报告PAS治疗症状性SHCs的结果。主要结局是症状缓解率或症状消失率。次要结果是囊肿体积缩小率和并发症发生率。亚组分析比较了乙醇和其他硬化剂。进行单臂荟萃分析，当观察到显著异质性（i2bb0 50%）时进行荟萃回归。随机对照试验采用Cochrane RoB2工具评估偏倚风险，非随机研究采用RoBANS2工具评估。结果：纳入16项研究。14项研究被评估为具有高偏倚风险。总症状缓解或消失率为86.9% （95% CI 80.2 ~ 91.6%, I2 = 0%）。囊肿体积缩小率为86.4% （95% CI 74.1 ~ 93.3%, I2 = 95%）。没有重大并发症。合并轻微并发症发生率疼痛为13.6% (95% CI 6.5-26.4%, I2 = 67.2%)，发热为7.4% （95% CI 4.1-13.0%, I2 = 38%）。亚组分析显示乙醇与其他硬化剂之间无显著差异。观察到囊肿体积缩小和疼痛的高度异质性，表明研究之间存在差异。对囊肿体积缩小率和疼痛的meta回归分析没有发现任何显著的关联。结论：对于有症状的SHCs患者，PAS似乎是一种相对安全有效的治疗选择，症状缓解率高，并发症发生率低。然而，鉴于现有证据的高偏倚风险和缺乏与手术治疗的直接比较，这些发现应谨慎解释。需要进一步的高质量比较研究来证实这些结果。
Percutaneous aspiration and sclerotherapy for simple hepatic cysts: a systematic review and meta-analysis.
Purpose: This systematic review aims to assess the efficacy and safety of percutaneous aspiration and sclerotherapy (PAS) for patients with symptomatic simple hepatic cysts (SHCs).
Materials and methods: We systematically searched the electronic databases of PubMed, Embase, the Cochrane Library and Ichushi-Web for studies published up to November 2024, reporting outcomes of PAS for symptomatic SHCs. The primary outcomes were rates of symptomatic relief or disappearance of symptoms. The secondary outcomes were cyst volume reduction rates and complication rates. Subgroup analyses compared ethanol with the other sclerosants. Single-arm meta-analyses were performed, with meta-regression conducted when substantial heterogeneity (I2 > 50%) was observed. Risk of bias was assessed using the Cochrane RoB2 tool for randomized controlled trials and RoBANS2 for non-randomized studies.
Results: Sixteen studies were included. Fourteen studies were assessed as having a high risk of bias. The pooled symptomatic relief or disappearance rate was 86.9% (95% CI 80.2-91.6%, I2 = 0%). The cyst volume reduction rate was 86.4% (95% CI 74.1-93.3%, I2 = 95%). There were no major complications. The pooled minor complication rates were 13.6% (95% CI 6.5-26.4%, I2 = 67.2%) for pain and 7.4% (95% CI 4.1-13.0%, I2 = 38%) for fever. Subgroup analysis showed no significant differences between ethanol and other sclerosants. High heterogeneity was observed for cyst volume reduction and pain, indicating variability across studies. Meta-regression analysis for cyst volume reduction rate and pain did not identify any significant associations.
Conclusion: PAS appears to be a relatively safe and effective treatment option for patients with symptomatic SHCs and provides high rates of symptomatic relief with low complication rates. However, given the high risk of bias in the available evidence and the lack of direct comparison with surgical treatment, these findings should be interpreted with caution. Further high-quality comparative studies are warranted to confirm these results.
期刊介绍：
Japanese Journal of Radiology is a peer-reviewed journal, officially published by the Japan Radiological Society. The main purpose of the journal is to provide a forum for the publication of papers documenting recent advances and new developments in the field of radiology in medicine and biology. The scope of Japanese Journal of Radiology encompasses but is not restricted to diagnostic radiology, interventional radiology, radiation oncology, nuclear medicine, radiation physics, and radiation biology. Additionally, the journal covers technical and industrial innovations. The journal welcomes original articles, technical notes, review articles, pictorial essays and letters to the editor. The journal also provides announcements from the boards and the committees of the society. Membership in the Japan Radiological Society is not a prerequisite for submission. Contributions are welcomed from all parts of the world.
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