Moss William J, Pang John, Orosco Ryan K, Weissbrod Philip A, Brumund Kevin T, Weisman Robert A, Brigger Matthew T, Coffey Charles S
Department of Surgery, division of Otolaryngology-Head & Neck Surgery, University of California, San Diego, California, U.S.A.
Department of Surgery, division of Otolaryngology-Head & Neck Surgery, VA San Diego Healthcare, La Jolla, California, U.S.A.
Laryngoscope. 2018 Jan;128(1):111-117. doi: 10.1002/lary.26618. Epub 2017 May 12.
To characterize the safety profile and effectiveness of esophageal dilation in head and neck cancer patients.
A systematic review was undertaken for articles reporting outcomes of esophageal dilation in head and neck cancer patients. The Medline, Scopus, Web of Science, and Cochrane databases were searched in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Complications related to esophageal dilation in head and neck cancer patients was the primary outcome of interest. Success rates, demographic data, cancer staging, and treatment data were assessed secondarily. Statistical analyses included both qualitative and quantitative assessments. A limited meta-analysis and pooling of the data was performed using a random effects model.
Of the collective 8,243 initial candidate articles, 15 retrospective studies containing data for a collective 449 patients were ultimately included in the analysis. There was significant heterogeneity in the outcomes data. With an overall complication rate of 10.6% (95% confidence interval [CI]: 4.1%,17%) and a pooled success rate of 72.9% (95% CI: 65.7%,80.1%) per patient, the articles generally supported the use of dilation.
Head and neck cancer patients experience a higher rate of complications following dilation compared to patients with other causes of benign stricture. Esophageal dilation is effective in improving dysphagia, but these benefits are often transient and thus necessitate repeat interventions. Laryngoscope, 128:111-117, 2018.
描述头颈部癌患者食管扩张术的安全性和有效性。
对报告头颈部癌患者食管扩张术结果的文章进行系统评价。根据系统评价和Meta分析的首选报告项目指南，检索了Medline、Scopus、Web of Science和Cochrane数据库。头颈部癌患者食管扩张相关并发症是主要关注的结果。其次评估成功率、人口统计学数据、癌症分期和治疗数据。统计分析包括定性和定量评估。使用随机效应模型进行了有限的Meta分析和数据合并。
在总共8243篇初始候选文章中，最终纳入分析的有15项回顾性研究，共包含449例患者的数据。结果数据存在显著异质性。总体并发症发生率为10.6%（95%置信区间[CI]：4.1%，17%），每位患者的合并成功率为72.9%（95%CI：65.7%，80.1%），这些文章总体上支持使用扩张术。
与其他良性狭窄病因的患者相比，头颈部癌患者扩张术后并发症发生率更高。食管扩张术在改善吞咽困难方面是有效的，但这些益处往往是短暂的，因此需要重复干预。《喉镜》，2018年，第128卷，第111 - 117页。
