Outcome and risk factors of ulcer healing after gastric endoscopic submucosal dissection: A systematic review and meta-analysis  

作　　者：De-Yi Chen Hai-Dong Chen Xiao-Dan Lv Zhou Huang Dan Jiang Yu Li Bing Han Li-Chun Han Xiao-Fang Xu Shi-Quan Li Guang-Fu Lin Zhi-Xi Huang Jia-Ning Lin Xiao-Ping Lv 

机构地区：[1]Department of Gastroenterology,The First Affiliated Hospital of Guangxi Medical University,Nanning 530021,Guangxi Zhuang Autonomous Region,China [2]Department of Gastroenterology,The Tenth Affiliated Hospital of Guangxi Medical University,Qinzhou 535000,Guangxi Zhuang Autonomous Region,China [3]Department of Clinical Experimental Medicine,The First Affiliated Hospital of Guangxi Medical University,Nanning 530021,Guangxi Zhuang Autonomous Region,China [4]Department of Emergency,The First Affiliated Hospital of Guangxi Medical University,Nanning 530021,Guangxi Zhuang Autonomous Region,China

出　　处：《World Journal of Gastrointestinal Surgery》2024年第11期3568-3577,共10页世界胃肠外科杂志（英文）

基　　金：Supported by the National Natural Science Foundation of China,No.81860104;the Joint Project on Regional High-Incidence Diseases Research of Guangxi Natural Science Foundation,No.2023GXNSFDA026024;the Development and Application of Medical and Health Appropriate Technology Project in Guangxi Zhuang Autonomous Region,No.S2018049;the Self-financing Project of Health Commission of Guangxi Zhuang Autonomous Region,No.Z20200398;the Innovation Project of Guangxi Graduate Education,No.YCBZ2022079.

摘　　要：BACKGROUND Endoscopic submucosal dissection(ESD)is widely utilized for the treatment of large adenomas,submucosal lesions,and early gastric cancer.A significant arti-ficial ulcer typically forms after ESD.Delayed or incomplete healing of these ulcers can result in complications such as delayed bleeding and perforation.However,a comprehensive review of the outcomes and risk factors related to ulcer healing following ESD is currently lacking.AIM To assess ulcer healing outcomes and identify risk factors associated with delayed ulcer healing.RESULTS Our analysis included 12 studies,involving a total of 3430 patients.The meta-analysis revealed an overall healing rate of 65.55%for ulcers following ESD[odds ratio(OR)=2.71;95%confidence interval(CI):2.45-3.00].The healing rate within eight weeks was 48.32%(OR=0.76;95%CI:0.35-1.66),while the rate beyond eight weeks was 88.32%(OR=6.73;95%CI:3.82-11.87).Risk factors included Helicobacter pylori(H.pylori)infection(OR:=5.32;95%CI:1.90-14.87;P=0.001),ulcer size(OR=2.08;95%CI:1.19-3.61;P=0.01),lesion site(OR=2.08;95%CI:1.19-3.11),and pathological type(OR=1.64;95%CI:1.06-2.52).Diabetes(OR=0.56;95%CI:0.05-5.80;P=0.63)and duration of operation(OR=1.00;95%CI:0.99-1.01;P=0.96)were not significant factors.CONCLUSION The healing rate of ulcers following ESD is high after eight weeks.Risk factors affecting the healing process include H.pylori infection,ulcer size,lesion site,and pathological type.

关 键 词：Endoscopic submucosal dissection Gastric ulcer Artificial ulcer OUTCOME Risk factors Systematic review META-ANALYSIS 

分 类 号：R735.2[医药卫生—肿瘤]