比较经肛门内镜显微手术和内镜黏膜下剥离术治疗直肠肿瘤的安全性和有效性的Meta分析  

Comparison of Efficacy and Safety Between Transanal Endoscopic Microsurgery and Endoscopic Submucosal Dissection to Treat Rectal Tumor: A Meta-Analysis

作　　者：柏丹 李权林 任明扬 Bo Dan;Li Quanlin;Ren Mingyang(Department of Gastrointestinal and Hernia Surgery,Nanchong Central Hospital,Nanchong,Sichuan 637000,China)

机构地区：[1]南充市中心医院胃肠外科,四川南充637000

出　　处：《四川医学》2022年第2期149-152,共4页Sichuan Medical Journal

基　　金：四川省医学会科研课题(编号:s19040)。

摘　　要：目的用Meta分析的方法,比较经肛门内镜显微手术(TEM)和内镜黏膜下剥离术(ESD)的安全性和有效性。方法检索Pubmed和万方数据库已公开发表的有关ESD和TEM手术治疗效果对比研究的所有临床文献。对符合条件的所有结果进行Meta分析,统计处理使用RevMan 5.0软件。结果共纳入分析的文献总样本量为710例,其中ESD手术组397例,观察组313例。纳入各研究的平均年龄为49.5~68.4岁。最终分析结果提示,ESD手术时间和住院天数明显短于TEM(P<0.00001和P=0.002)。但由于样本数太少,在R0切除率和术后复发率方面,差异无统计学意义。结论传统的TEM手术在治疗直肠肿瘤方面相对ESD没有任何优势,改良的TEM手术是将来发展的趋势,将和ESD形成治疗方式上的互补。Objective To compare the efficacy and safety between transanal endoscopic microsurgery(TEM)and endoscopic submucosal dissection(ESD)using Meta-analysis. Methods Pubmed and Wanfang database to identify literature comparing ESD with TEM for rectal tumor. Data were analyzed using Revman5.0 statistical software.Results 710 cases were included, including 397 patients received ESD and 313 patients received TEM. The average age ranged 49.5~68.4 years. Compared to TEM, procedure time and hospital stay were shorter for ESD(P<0.00001 andP=0.002, respectively). However, due to small number of samples, there was no significant differences between R0 resection rates and postoperative recurrence rate. Conclusion Comparing with ESD, TEM has no advantage for rectal tumor. Modified TEM would replace TEM to treat rectal tumors.

关 键 词：经肛门内镜显微手术 内镜黏膜下剥离术 直肠肿瘤 

分 类 号：R574.63[医药卫生—消化系统]