内镜超声引导下胃造口术治疗胃出口梗阻的临床效果：系统评价和荟萃分析。
Clinical outcomes of endoscopic ultrasound-guided gastroenterostomy for gastric outlet obstruction: a systematic review and meta-analysis.
机构信息
Digestive Endoscopy Department and General Surgery Department, The First Affiliated Hospital with Nanjing Medical University and Jiangsu Province Hospital, Nanjing, China.
Department of Gastroenterology, Affiliated Hospital of Southwest Medical University, Luzhou, China.
出版信息
Minim Invasive Ther Allied Technol. 2022 Feb;31(2):159-167. doi: 10.1080/13645706.2020.1792500. Epub 2020 Jul 16.
BACKGROUND AND AIMS
EUS-guided gastroenterostomy (EUS-GE) has been used for gastric outlet obstruction (GOO) with promising clinical outcomes. Therefore, we aimed to determine the clinical outcomes of EUS-GE for GOO.
MATERIAL AND METHODS
We used the keyword 'EUS-guided gastroenterostomy' to search in Pubmed, Web of science, Cochrane databases. Clinical outcomes of EUS-GE were evaluated in terms of technical success, clinical success and complications.
RESULTS
Ten studies reported 297 patients managed with EUS-GE. Weighted pooled rates (WPR) for technical success, clinical success and complications of EUS-GE were 91% (95%CI 87%-94%), 88% (95%CI 83%-91%) and 6.8% (95%CI 4.1%-11.0%). The most common complications were abdominal pain, 6.7% (95%CI 2.5%-16.5%) and bleeding, 4.8% (95%CI 1.5%-13.9%). Two studies compared EUS-GE with surgical gastrojejunostomy (SGJ). Pooled risk ratio (RR) for technical success, clinical success and complications were 0.87 (0.78, 0.97), = 0%; 0.92 (0.82, 1.04), = 0%; 0.28 (0.11, 0.68), = 0%. Three studies compared benign GOO with malignant GOO. RR for technical success and clinical success were 1.05 (0.82, 1.34), = 0%; 0.98 (0.72, 1.33), = 0%.
CONCLUSIONS
Although EUS-GE and SGJ had similar clinical success rates, EUS-GE had a lower complication rate. EUS-GE is a safe, effective, and minimally invasive choice for patients with GOO.
背景与目的
超声内镜引导下胃造口术（EUS-GE）已被用于治疗胃出口梗阻（GOO），并取得了良好的临床效果。因此，我们旨在确定 EUS-GE 治疗 GOO 的临床效果。
材料与方法
我们使用关键词“EUS-guided gastroenterostomy”在 Pubmed、Web of science、Cochrane 数据库中进行搜索。通过技术成功率、临床成功率和并发症来评估 EUS-GE 的临床效果。
结果
10 项研究报告了 297 例接受 EUS-GE 治疗的患者。EUS-GE 的技术成功率、临床成功率和并发症的加权汇总率（WPR）分别为 91%（95%CI 87%-94%）、88%（95%CI 83%-91%）和 6.8%（95%CI 4.1%-11.0%）。最常见的并发症是腹痛，发生率为 6.7%（95%CI 2.5%-16.5%）和出血，发生率为 4.8%（95%CI 1.5%-13.9%）。有两项研究比较了 EUS-GE 与外科胃空肠吻合术（SGJ）。技术成功率、临床成功率和并发症的汇总风险比（RR）分别为 0.87（0.78, 0.97）， = 0%；0.92（0.82, 1.04）， = 0%；0.28（0.11, 0.68）， = 0%。有三项研究比较了良性 GOO 与恶性 GOO。技术成功率和临床成功率的 RR 分别为 1.05（0.82, 1.34）， = 0%；0.98（0.72, 1.33）， = 0%。
结论
尽管 EUS-GE 和 SGJ 的临床成功率相似，但 EUS-GE 的并发症发生率较低。EUS-GE 是治疗 GOO 患者的一种安全、有效且微创的选择。
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