Gastroenterology, The Second Xiangya Hospital of Central South Unive, China.
Rev Esp Enferm Dig. 2021 Jan;113(1):52-59. doi: 10.17235/reed.2020.6989/2020.
submucosal tunneling endoscopic resection (STER) can be an effective treatment for submucosal tumors (SMTs) in the esophagus and cardia. However, STER may be more difficult to perform in the stomach than in the esophagus due to special anatomical and physiological features. The feasibility of STER to remove gastric STMs has not been systematically investigated. Therefore, this meta-analysis aimed to evaluate the safety and efficacy of STER for gastric SMTs.
a comprehensive literature search of the Medline, Embase, PubMed, and Cochrane Library databases was conducted. Complete resection and en-bloc resection rates were considered as the primary outcome measures. The secondary outcome measure was the pooled estimate of complications.
nine studies including 301 patients with 305 lesions were finally included. The pooled estimate of en-bloc resections was 95.1 % (95 % CI: 88.9-97.9 %), Cochran's Q-test, p = 0.151, and the weighted pooled rate (WPR) for complete resection was 97.9 % (95 % CI: 93.6-99.3 %), Cochran's Q-test, p = 0.778. In addition, the pooled estimate of gas-related complications was 8.7 % (95 % CI: 4.6-15.9 %), Cochran's Q-test, p = 0.057. The pooled estimate for mucosal laceration was 4.2 % (95 % CI: 2.2-7.9 %), Cochran's Q-test, p = 0.572. The pooled estimate for delayed bleeding was 2.1 % (95 % CI: 0.9-4.8 %), Cochran's Q-test, p = 0.985. The pooled estimate of inflammation-related complications was 8.6 % (95 % CI: 5.2-13.9 %), Cochran's Q-test, p = 0.308.
STER is an effective and safe technique for removing gastric SMTs with low complications, and complications, when encountered, can be treated conservatively.
黏膜下隧道内镜切除术（STER）可以是一种有效的治疗方法对于食管和贲门的黏膜下肿瘤（SMT）。然而，由于特殊的解剖和生理特点，STER 在胃中可能比在食管中更难进行。STER 切除胃 SMT 的可行性尚未得到系统研究。因此，本荟萃分析旨在评估STER 治疗胃 SMT 的安全性和有效性。
对 Medline、Embase、PubMed 和 Cochrane Library 数据库进行全面文献检索。完整切除和整块切除率被认为是主要的观察指标。次要观察指标是并发症的汇总估计。
最终纳入了 9 项研究，共 301 例患者，305 个病灶。整块切除的汇总估计为 95.1%（95%CI：88.9-97.9%），Cochran's Q 检验，p = 0.151，完全切除的加权汇总率（WPR）为 97.9%（95%CI：93.6-99.3%），Cochran's Q 检验，p = 0.778。此外，与气体相关的并发症的汇总估计为 8.7%（95%CI：4.6-15.9%），Cochran's Q 检验，p = 0.057。黏膜撕裂伤的汇总估计为 4.2%（95%CI：2.2-7.9%），Cochran's Q 检验，p = 0.572。延迟性出血的汇总估计为 2.1%（95%CI：0.9-4.8%），Cochran's Q 检验，p = 0.985。与炎症相关的并发症的汇总估计为 8.6%（95%CI：5.2-13.9%），Cochran's Q 检验，p = 0.308。
STER 是一种有效且安全的技术，用于切除胃 SMT，并发症低，当出现并发症时，可以保守治疗。
