Abstract：
BACKGROUND: Gastric band erosion may be seen in up to 3% of patients. Endoscopic intervention has become increasingly utilized due to its minimally invasive nature. The purpose of this study was to perform a systematic review and meta-analysis to examine the role of endoscopic removal for eroded gastric bands.
METHODS: Individualized search strategies were developed for PubMed, EMBASE, Web of Science, and Cochrane Library databases in accordance with PRISMA and MOOSE guidelines. Outcomes included technical success, clinical success, procedure duration, adverse events, and surgical conversion. Pooled proportions were analyzed using random effects models. Heterogeneity and publication bias was assessed with I2 statistics and funnel plot asymmetry using Egger and Begg tests. Meta-regression was also performed comparing outcomes by endoscopic tools.
RESULTS: Ten studies (n=282 patients) were included in this meta-analysis. Mean age was 40.68±7.25 years with average duration of band placement of 38.49±19.88 months. Pre-operative BMI was 42.76±1.06 kg/m2 with BMI of 33.06±3.81 kg/m2 at time of band erosion treatment. Endoscopic removal was attempted in 240/282 (85.11%) of cases. Pooled technical and clinical success of the endoscopic therapy was 86.08% (95% CI: 79.42-90.83; I2=28.62%) and 85.34% (95% CI: 88.70-90.62; I2=38.56%), respectively. Mean procedure time for endoscopic removal was 46.47±11.52 min with an intra-operative adverse event rate of 4.15% (95% CI: 1.98-8.51; I2=0.00%). Post-procedure-associated adverse events occurred in 7.24% (CI: 4.46-11.55; I2=0.00%) of patients. Conversion to laparotomy/laparoscopy occurred in 10.54% (95% CI: 6.12-17.54) of cases.
CONCLUSIONS: Endoscopic intervention is a highly effective and safe modality for the treatment of gastric band erosion.
METHODS: Individualized search strategies were developed for PubMed, EMBASE, Web of Science, and Cochrane Library databases in accordance with PRISMA and MOOSE guidelines. Outcomes included technical success, clinical success, procedure duration, adverse events, and surgical conversion. Pooled proportions were analyzed using random effects models. Heterogeneity and publication bias was assessed with I2 statistics and funnel plot asymmetry using Egger and Begg tests. Meta-regression was also performed comparing outcomes by endoscopic tools.
RESULTS: Ten studies (n=282 patients) were included in this meta-analysis. Mean age was 40.68±7.25 years with average duration of band placement of 38.49±19.88 months. Pre-operative BMI was 42.76±1.06 kg/m2 with BMI of 33.06±3.81 kg/m2 at time of band erosion treatment. Endoscopic removal was attempted in 240/282 (85.11%) of cases. Pooled technical and clinical success of the endoscopic therapy was 86.08% (95% CI: 79.42-90.83; I2=28.62%) and 85.34% (95% CI: 88.70-90.62; I2=38.56%), respectively. Mean procedure time for endoscopic removal was 46.47±11.52 min with an intra-operative adverse event rate of 4.15% (95% CI: 1.98-8.51; I2=0.00%). Post-procedure-associated adverse events occurred in 7.24% (CI: 4.46-11.55; I2=0.00%) of patients. Conversion to laparotomy/laparoscopy occurred in 10.54% (95% CI: 6.12-17.54) of cases.
CONCLUSIONS: Endoscopic intervention is a highly effective and safe modality for the treatment of gastric band erosion.
摘要：
背景：高达3%的患者可能会出现胃带侵蚀。内窥镜介入由于其微创性质而变得越来越多地被利用。这项研究的目的是进行系统评价和荟萃分析，以检查内镜下去除侵蚀胃带的作用。
方法：为PubMed开发了个性化搜索策略，EMBASE,WebofScience,和Cochrane图书馆数据库符合PRISMA和MOOSE指南。成果包括技术成功，临床成功，程序持续时间,不良事件,和手术转换。使用随机效应模型分析集合比例。使用Egger和Begg检验，通过I2统计量和漏斗图不对称性评估异质性和发表偏倚。还通过内镜工具进行Meta回归比较结果。
结果：10项研究（n=282例患者）纳入本荟萃分析。平均年龄为40.68±7.25岁，平均条带放置时间为38.49±19.88个月。术前BMI为42.76±1.06kg/m2，带蚀治疗时BMI为33.06±3.81kg/m2。在240/282例（85.11％）的病例中尝试了内窥镜切除。内镜治疗的技术和临床成功率分别为86.08%(95%CI:79.42-90.83;I2=28.62%)和85.34%(95%CI:88.70-90.62;I2=38.56%),分别。内镜下切除的平均手术时间为46.47±11.52min，术中不良事件发生率为4.15%（95%CI：1.98-8.51；I2=0.00%）。术后相关不良事件发生率为7.24%(CI:4.46-11.55;I2=0.00%)。在10.54％（95％CI：6.12-17.54）的病例中发生了剖腹手术/腹腔镜检查。
结论：内镜介入治疗胃束带糜烂是一种非常有效和安全的方法。
方法：为PubMed开发了个性化搜索策略，EMBASE,WebofScience,和Cochrane图书馆数据库符合PRISMA和MOOSE指南。成果包括技术成功，临床成功，程序持续时间,不良事件,和手术转换。使用随机效应模型分析集合比例。使用Egger和Begg检验，通过I2统计量和漏斗图不对称性评估异质性和发表偏倚。还通过内镜工具进行Meta回归比较结果。
结果：10项研究（n=282例患者）纳入本荟萃分析。平均年龄为40.68±7.25岁，平均条带放置时间为38.49±19.88个月。术前BMI为42.76±1.06kg/m2，带蚀治疗时BMI为33.06±3.81kg/m2。在240/282例（85.11％）的病例中尝试了内窥镜切除。内镜治疗的技术和临床成功率分别为86.08%(95%CI:79.42-90.83;I2=28.62%)和85.34%(95%CI:88.70-90.62;I2=38.56%),分别。内镜下切除的平均手术时间为46.47±11.52min，术中不良事件发生率为4.15%（95%CI：1.98-8.51；I2=0.00%）。术后相关不良事件发生率为7.24%(CI:4.46-11.55;I2=0.00%)。在10.54％（95％CI：6.12-17.54）的病例中发生了剖腹手术/腹腔镜检查。
结论：内镜介入治疗胃束带糜烂是一种非常有效和安全的方法。
