UNASSIGNED:关于内镜切除术(ER)和腹腔镜切除术(LR)治疗胃肠道间质瘤(GISTs)的疗效和安全性仍存在临床争议。本研究旨在通过比较ER与LR的相对结局来评估ER治疗GIST的安全性和有效性。
未经授权:PubMed,WebofScience,科克伦图书馆,Embase被搜查了.从2010年1月至2020年1月检索数据,并根据ER和LR的术中和术后结果进行荟萃分析。干预臂由LR治疗,而比较臂由ER治疗。根据纳入标准选择了相关文献,数据被提取,并对纳入文献进行质量评价。采用纽卡斯尔-渥太华量表(NOS)评估纳入研究的质量。使用Cochraneχ2检验和I2统计量评估研究之间的异质性,漏斗图和Egger检验用于检测发表偏倚。
未经评估:本分析包括13项研究,共有1,261名患者,(ERvs.LR:543vs.718).术后并发症的发生率[比值比(OR),0.400;P=0.001]在ER组明显更低[3.3%;95%置信区间(CI),LR组的0.015~0.055](8.9%;95%CI,0.03~0.17)。荟萃分析显示,ER后的复发率(1.7%;95%CI,0.005至0.033)低于LR后的复发率(2.5%;95%CI,0.012至0.041)。ER的R0切除率(99%;95%CI,0.975至0.999)与LR的R0切除率(100%;95%CI,0.995至1.000)相似。本研究无发表偏倚(P>0.10),敏感性分析表明该研究是稳健的。
未经评估:就所有结果而言,ER比LR更安全,更有效,除R0切除率外。因此,应考虑ER的治疗选择。然而,应注意ER后的手术切缘状况。
UNASSIGNED: There are still clinical controversy on the efficacy and safety of endoscopic resection (ER) and laparoscopic resection (LR) in the treatment of gastrointestinal stromal tumors (GISTs). The present study aimed to evaluate the safety and efficacy of ER in the treatment of GISTs by comparing the relative outcomes of ER to LR.
UNASSIGNED: PubMed, Web of Science, Cochrane Library, and Embase were searched. Data were retrieved from January 2010 to January 2020 and subjected to a meta-analysis based on the intraoperative and postoperative outcomes of ER and LR. The intervention arm was treated by LR while the comparator arm was treated by ER. Relevant literature was selected based on the inclusion criteria, data was extracted, and quality evaluation of the included literature was carried out. The Newcastle-Ottawa Scale (NOS) was applied for assessing the quality of included studies. Heterogeneity between studies was assessed using the Cochrane χ2 test and I2 statistic, and Funnel plots and Egger\'s test were used to detect publication bias.
UNASSIGNED: The present analysis included 13 studies, comprising a total of 1,261 patients, (ER vs. LR: 543 vs. 718). The incidence rate of postoperative complications [odds ratio (OR), 0.400; P=0.001] was significantly lower in the ER group [3.3%; 95% confidence interval (CI), 0.015 to 0.055] than the LR group (8.9%; 95% CI, 0.03 to 0.17). The meta-analysis revealed that the recurrence rate following ER (1.7%; 95% CI, 0.005 to 0.033) was lower than that following LR (2.5%; 95% CI, 0.012 to 0.041). The R0 resection rate of ER (99%; 95% CI, 0.975 to 0.999) was similar to that of LR (100%; 95% CI, 0.995 to 1.000). No publication bias in this study (P>0.10), and the sensitivity analysis showed that the study was robust.
UNASSIGNED: ER was safer and more efficient than LR in terms of all the outcomes, except the R0 resection rate. Thus, ER should be considered the treatment of choice. However, attention should be paid to the surgical margin status following ER.