PDF(Pubmed)
Abstract：
BACKGROUND: Peroral endoscopic myotomy is an increasingly used less invasive modality to treat esophageal dysmotility. Recently, triangular tip knife with integrated water jet function has been introduced to mitigate multiple instrument exchanges.
OBJECTIVE: To compare traditional triangular tip knife and water jet knife in terms of procedural success, duration, instrument exchanges, coagulation forceps use, and adverse events.
METHODS: We conducted a systemic review and meta-analysis with two authors independently in electronic databases (PubMed, Embase, and Cochrane Library) from inception through May 2021. In addition, we conducted a relevant search by Reference Citation Analysis (RCA) (https://www.referencecitationanalysis.com). A fixed-effects model was used to calculate weighted mean, odds ratio (OR), and confidence intervals (CI).
RESULTS: We included 7 studies involving 558 patients. Triangular knife and water jet knife were similar in odds of procedural success with ratio of 4.78 (95%CI = 0.22-102.47) and odds of clinical success with ratio of 0.93 (95%CI = 0.29-2.97), respectively. Water jet knife had fewer instrument exchanges compared to triangular knife (2.21, 95%CI = 1.98-2.45 vs 11.9, 95%CI = 11.15-12.70) and usage of coagulation forceps (1.75, 95%CI = 1.52-1.97 vs 2.63, 95%CI = 2.37-2.89). Adverse events were higher in triangular knife group (OR: 2.30, 95%CI = 1.35-3.95).
CONCLUSIONS: Peroral endoscopic myotomy using water jet knife is comparable in terms of procedural success to triangular tip knife. Water jet knife also required shorter procedural duration, less instrument exchanges, coagulation devices, and overall adverse events.
OBJECTIVE: To compare traditional triangular tip knife and water jet knife in terms of procedural success, duration, instrument exchanges, coagulation forceps use, and adverse events.
METHODS: We conducted a systemic review and meta-analysis with two authors independently in electronic databases (PubMed, Embase, and Cochrane Library) from inception through May 2021. In addition, we conducted a relevant search by Reference Citation Analysis (RCA) (https://www.referencecitationanalysis.com). A fixed-effects model was used to calculate weighted mean, odds ratio (OR), and confidence intervals (CI).
RESULTS: We included 7 studies involving 558 patients. Triangular knife and water jet knife were similar in odds of procedural success with ratio of 4.78 (95%CI = 0.22-102.47) and odds of clinical success with ratio of 0.93 (95%CI = 0.29-2.97), respectively. Water jet knife had fewer instrument exchanges compared to triangular knife (2.21, 95%CI = 1.98-2.45 vs 11.9, 95%CI = 11.15-12.70) and usage of coagulation forceps (1.75, 95%CI = 1.52-1.97 vs 2.63, 95%CI = 2.37-2.89). Adverse events were higher in triangular knife group (OR: 2.30, 95%CI = 1.35-3.95).
CONCLUSIONS: Peroral endoscopic myotomy using water jet knife is comparable in terms of procedural success to triangular tip knife. Water jet knife also required shorter procedural duration, less instrument exchanges, coagulation devices, and overall adverse events.
摘要：
背景：经口内镜下肌切开术越来越多地用于治疗食管动力障碍。最近,已引入具有集成水射流功能的三角尖刀，以减轻多种仪器交换。
目的：比较传统三角尖刀和喷水刀的手术成功率，持续时间,仪器交换，使用凝血钳，和不良事件。
方法：我们在电子数据库中独立与两名作者进行了系统综述和荟萃分析（PubMed，Embase,和Cochrane图书馆）从成立到2021年5月。此外,我们通过参考引文分析(RCA)(https://www.referencecitationanalysis.com)。使用固定效应模型来计算加权平均值，比值比(OR)，和置信区间(CI)。
结果：我们纳入了7项研究，涉及558名患者。三角刀和水刀的手术成功率相似，比率为4.78（95CI=0.22-102.47），临床成功率为0.93（95CI=0.29-2.97），分别。与三角刀（2.21，95CI=1.98-2.45vs11.9，95CI=11.15-12.70）和使用凝血钳（1.75，95CI=1.52-1.97vs2.63，95CI=2.37-2.89）相比，喷水刀的器械更换较少。三角刀组不良事件发生率较高(OR:2.30,95CI=1.35~3.95)。
结论：使用水刀的经口内镜肌切开术在手术成功率方面与三角尖刀相当。喷水刀还需要更短的程序持续时间，较少的仪器交换，凝血装置,和总体不良事件。
目的：比较传统三角尖刀和喷水刀的手术成功率，持续时间,仪器交换，使用凝血钳，和不良事件。
方法：我们在电子数据库中独立与两名作者进行了系统综述和荟萃分析（PubMed，Embase,和Cochrane图书馆）从成立到2021年5月。此外,我们通过参考引文分析(RCA)(https://www.referencecitationanalysis.com)。使用固定效应模型来计算加权平均值，比值比(OR)，和置信区间(CI)。
结果：我们纳入了7项研究，涉及558名患者。三角刀和水刀的手术成功率相似，比率为4.78（95CI=0.22-102.47），临床成功率为0.93（95CI=0.29-2.97），分别。与三角刀（2.21，95CI=1.98-2.45vs11.9，95CI=11.15-12.70）和使用凝血钳（1.75，95CI=1.52-1.97vs2.63，95CI=2.37-2.89）相比，喷水刀的器械更换较少。三角刀组不良事件发生率较高(OR:2.30,95CI=1.35~3.95)。
结论：使用水刀的经口内镜肌切开术在手术成功率方面与三角尖刀相当。喷水刀还需要更短的程序持续时间，较少的仪器交换，凝血装置,和总体不良事件。
