内镜治疗与手术治疗胰腺假性囊肿的系统评价和荟萃分析
Endoscopic versus surgical treatment for pancreatic pseudocysts: Systematic review and meta-analysis.
作者信息
Farias Galileu F A, Bernardo Wanderley M, De Moura Diogo T H, Guedes Hugo G, Brunaldi Vitor O, Visconti Thiago A de C, Gonçalves Caio V T, Sakai Christiano M, Matuguma Sergio E, Santos Marcos E L Dos, Sakai Paulo, De Moura Eduardo G H
机构信息
Gastroenterology Department, Gastrointestinal Endoscopy Unit, University of Sao Paulo School of Medicine, Avenida Dr. Enéas de Carvalho Aguiar.
Thoracic Surgery Department, Instituto do Coração (InCor, Heart Institute), University of Sao Paulo School of Medicine, São Paulo, Brazil.
出版信息
Medicine (Baltimore). 2019 Feb;98(8):e14255. doi: 10.1097/MD.0000000000014255.
OBJECTIVE
This systematic review and meta-analysis aims to compare surgical and endoscopic treatment for pancreatic pseudocyst (PP).
METHODS
The researchers did a search in Medline, EMBASE, Scielo/Lilacs, and Cochrane electronic databases for studies comparing surgical and endoscopic drainage of PP s in adult patients. Then, the extracted data were used to perform a meta-analysis. The outcomes were therapeutic success, drainage-related adverse events, general adverse events, recurrence rate, cost, and time of hospitalization.
RESULTS
There was no significant difference between treatment success rate (risk difference [RD] -0.09; 95% confidence interval [CI] [0.20,0.01]; P = .07), drainage-related adverse events (RD -0.02; 95% CI [-0.04,0.08]; P = .48), general adverse events (RD -0.05; 95% CI [-0.12, 0.02]; P = .13) and recurrence (RD: 0.02; 95% CI [-0.04,0.07]; P = .58) between surgical and endoscopic treatment.Regarding time of hospitalization, the endoscopic group had better results (RD: -4.23; 95% CI [-5.18, -3.29]; P < .00001). When it comes to treatment cost, the endoscopic arm also had better outcomes (RD: -4.68; 95% CI [-5.43,-3.94]; P < .00001).
CONCLUSION
There is no significant difference between surgical and endoscopic treatment success rates, adverse events and recurrence for PP. However, time of hospitalization and treatment costs were lower in the endoscopic group.
目的
本系统评价和荟萃分析旨在比较手术治疗与内镜治疗胰腺假性囊肿（PP）的效果。
方法
研究人员在Medline、EMBASE、Scielo/Lilacs和Cochrane电子数据库中检索比较成年患者PP手术引流与内镜引流的研究。然后，提取的数据用于进行荟萃分析。结局指标包括治疗成功率、引流相关不良事件、一般不良事件、复发率、费用和住院时间。
结果
手术治疗与内镜治疗在治疗成功率（风险差[RD] -0.09；95%置信区间[CI] [-0.20,0.01]；P = 0.07）、引流相关不良事件（RD -0.02；95% CI [-0.04,0.08]；P = 0.48）、一般不良事件（RD -0.05；95% CI [-0.12, 0.02]；P = 0.13）和复发率（RD: 0.02；95% CI [-0.04,0.07]；P = 0.58）方面无显著差异。在住院时间方面，内镜组效果更好（RD: -4.23；95% CI [-5.18, -3.29]；P < 0.00001）。在治疗费用方面，内镜组也有更好的结果（RD: -4.68；95% CI [-5.43,-3.94]；P < 0.00001）。
结论
手术治疗与内镜治疗PP的成功率、不良事件和复发率无显著差异。然而，内镜组的住院时间和治疗费用较低。
Zotero 插件