Wang Jing, Zhang Xiao-Hua, Ge Jian, Yang Chong-Mei, Liu Ji-Yong, Zhao Shu-Lei
Jing Wang, Xiao-Hua Zhang, Jian Ge, Chong-Mei Yang, Ji-Yong Liu, Shu-Lei Zhao, Department of Gastroenterology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan 250021, Shandong Province, China.
World J Gastroenterol. 2014 Jul 7;20(25):8282-7. doi: 10.3748/wjg.v20.i25.8282.
To compare the efficacy and safety of endoscopic submucosal dissection (ESD) and endoscopic mucosal resection (EMR) for the treatment of colorectal tumors.
Databases, such as PubMed, EMBASE, Cochrane Library and Science Citation Index updated to 2013 were searched to include eligible articles. In the meta-analysis, the main outcome measurements were the en bloc resection rate, the histological resection rate and the local recurrence rate. Meanwhile, we also compared the operation time and the incidence of procedure-related complications.
Six trials were identified and a total of 1642 lesions were included. The en bloc resection rate was higher and the local recurrence rate was lower in the ESD group compared with the EMR group (OR = 7.94; 95%CI: 3.96-15.91; OR = 0.09; 95%CI: 0.04-0.19). There was no significant difference in histological resection rate(OR = 1.65; 95%CI: 0.29-9.30) and procedure-related complication rate between the two groups (OR = 1.59; 95%CI: 0.92-2.73). The meta-analysis also showed that ESD was more time consuming than EMR.
Compared with EMR, ESD results in higher en bloc resection rate and lower local recurrence rate for the treatment of colorectal tumors, without increasing the procedure-related complications.
比较内镜黏膜下剥离术（ESD）与内镜黏膜切除术（EMR）治疗结直肠肿瘤的疗效和安全性。
检索截至2013年更新的PubMed、EMBASE、Cochrane图书馆和科学引文索引等数据库，纳入符合条件的文章。在荟萃分析中，主要观察指标为整块切除率、组织学切除率和局部复发率。同时，我们还比较了手术时间和手术相关并发症的发生率。
共纳入6项试验，总计1642个病灶。与EMR组相比，ESD组的整块切除率更高，局部复发率更低（OR = 7.94；95%CI：3.96 - 15.91；OR = 0.09；95%CI：0.04 - 0.19）。两组间组织学切除率（OR = 1.65；95%CI：0.29 - 9.30）和手术相关并发症发生率无显著差异（OR = 1.59；95%CI：0.92 - 2.73）。荟萃分析还显示，ESD比EMR耗时更长。
与EMR相比，ESD治疗结直肠肿瘤的整块切除率更高，局部复发率更低，且不增加手术相关并发症。
