Liu Sifan, Tian Zibin, Jiang Yueping, Mao Tao, Ding Xueli, Jing Xue
Department of Gastroenterology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong Province, China.
J Minim Access Surg. 2022 Oct-Dec;18(4):489-496. doi: 10.4103/jmas.jmas_349_21.
Ultrasound (US)- or computed tomography-guided drainage for abdominal abscess is currently the first-line options for drainage, but both options have disadvantages. Patients without adequate windows for drainage mostly undergo surgical drainage. However, surgical drainage is invasive and expensive. Endoscopic US (EUS)-guided drainage is a minimally invasive alternative for abdominal abscess, but there is less consensus on its efficacy, safety and complications. This meta-analysis aims to evaluate EUS-guided drainage for abdominal abscess.
We retrieved relevant papers on EUS-guided drainage for abdominal abscess from the PubMed, Cochrane Library, Web of Science and EMBASE databases. Each paper was reviewed, and data were extracted. We used R software version 3.6.3 to perform the meta-analysis. Fixed effects models were used for merging data.
A total of 11 papers met the inclusion criteria, with a total sample population of 264 patients. The meta-analysis showed that the pooled clinical success rate was 90% (95% confidence interval [CI], 0.85-0.95), the technical success rate was 99% (95% CI, 0.97-1.00) and the recurrence rate was 1% (95% CI, 0.00-0.03). Three studies reported the complications, including perforation, bleeding and stent migration; none of the other eight studies reported complications. There were no significant differences between subgroups. There was no publication bias in either the clinical or the technical success rates.
This meta-analysis showed that EUS-guided drainage for abdominal abscess was effective and safe, with an excellent technical success rate. In addition, EUS-guided drainage could be used for abscesses with complex anatomy. Nevertheless, complications and stent type should be considered.
腹部脓肿的超声（US）或计算机断层扫描引导下引流目前是引流的一线选择，但这两种选择都有缺点。没有足够引流窗口的患者大多接受手术引流。然而，手术引流具有侵入性且费用高昂。内镜超声（EUS）引导下引流是腹部脓肿的一种微创替代方法，但关于其疗效、安全性和并发症的共识较少。本荟萃分析旨在评估EUS引导下腹部脓肿引流的效果。
我们从PubMed、Cochrane图书馆、科学网和EMBASE数据库中检索了关于EUS引导下腹部脓肿引流的相关论文。对每篇论文进行了审查，并提取了数据。我们使用R软件3.6.3版进行荟萃分析。采用固定效应模型合并数据。
共有11篇论文符合纳入标准，总样本量为264例患者。荟萃分析显示，合并临床成功率为90%（95%置信区间[CI]，0.85 - 0.95），技术成功率为99%（95%CI，0.97 - 1.00），复发率为1%（95%CI，0.00 - 0.03）。三项研究报告了并发症，包括穿孔、出血和支架移位；其他八项研究均未报告并发症。亚组间无显著差异。临床或技术成功率均无发表偏倚。
本荟萃分析表明，EUS引导下腹部脓肿引流有效且安全，技术成功率高。此外，EUS引导下引流可用于解剖结构复杂的脓肿。然而，应考虑并发症和支架类型。
