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内镜下支架置入与胃空肠吻合术治疗恶性胃出口梗阻的姑息性比较。

Endoscopic stenting versus gastrojejunostomy for palliation of malignant gastric outlet obstruction.

机构信息

Evidence Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China.

出版信息

Dig Endosc. 2012 Mar;24(2):71-8. doi: 10.1111/j.1443-1661.2011.01186.x. Epub 2011 Jul 20.

Abstract

The aim of the present study was to analyze endoscopic stenting versus gastrojejunostomy of malignant gastric outlet obstruction (GOO). A systematic review of the literature was undertaken to analyze clinical trials on GOO. Six studies were eligible for analysis (three randomized control trials and three controlled clinical trials). Technical success (OR [95% CI]: 0.10 [0.02, 0.47]; I(2) = 0%; P = 0.003) and minor complications (OR [95% CI]: 0.28 [0.10, 0.83]; I(2) = 49%; P = 0.02). Time to oral intake and length of survival were also shorter in the endoscopic stenting (ES) group. There was no statistically significant difference in clinical success, length of survival, mortality and major complications. The present review demonstrated potentially improved quality of life in the ES group. ES is a safe and effective, minimally invasive and cost-effective option for palliation of malignant gastric outlet obstruction. The present review provides supportive evidence that ES should be considered as the gold standard treatment for malignant GOO.

摘要

本研究旨在分析内镜支架置入术与恶性胃出口梗阻(GOO)胃空肠吻合术的疗效。对 GOO 的临床试验进行了系统评价分析。有 6 项研究符合分析标准(3 项随机对照试验和 3 项对照临床试验)。技术成功率(OR [95%CI]:0.10 [0.02,0.47];I² = 0%;P = 0.003)和轻微并发症(OR [95%CI]:0.28 [0.10,0.83];I² = 49%;P = 0.02)。内镜支架置入术(ES)组的口服摄入时间和生存时间也更短。临床成功率、生存时间、死亡率和主要并发症方面无统计学差异。本综述表明 ES 组的生活质量可能得到改善。ES 是一种安全有效的微创、具有成本效益的恶性胃出口梗阻姑息治疗选择。本综述提供了支持性证据,表明 ES 应被视为恶性 GOO 的金标准治疗方法。

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