Gastroenterology Unit, Asst-Bergamoest, 24068 Bergamo, Italy.
Gastroenterology Unit, Department of Medical and Surgical Sciences, University of Foggia, 71122 Foggia, Italy.
Medicina (Kaunas). 2023 Feb 14;59(2):359. doi: 10.3390/medicina59020359.
: The development of dedicated endoscopes and the technical evolution of endoscopic ultrasound (EUS) have allowed a direct approach to pancreatic neoplastic lesions both for diagnosis and treatment. Among the more promising targets are pancreatic neuroendocrine tumors (Pan-NETs). : to describe the evolution of endoscopic ultrasound-guided radiofrequency ablation (EUS-RFA) with particular attention to the treatment of PanNETs, focusing on safety and clinical efficacy of the technique. : MEDLINE, Scopus, and Cochrane Library databases were searched for studies reporting about EUS-RFA for the treatment of PanNETs. Studies with outcomes of interest were selected and results were reported to describe clinical success, complications, fol-low-ups, and electrodes used. Clinical success was defined as the disappearance of clinical symp-toms for functional (F-) PanNETs and as complete ablation per nonfunctional (NF)-PanNETs. The pooled data were analyzed by a random-effects model. : Nineteen studies were selected, including 183 patients (82 males, 44.8%) with 196 lesions (101 F-PanNETs and 95 NF-PanNETs). Pooled estimates for the overall AE rates for the clinical efficacy were 17.8% (95% CI 9.1-26.4%) and 95.1% (95% CI 91.2-98.9%) for F-PanNETs and 24.6% (95% CI 7.4-41.8%) and 93.4% (95% CI 88.4-98.4%) for NF-PanNETs. : EUS-RFA appears to be a mini-invasive technique with a good safety and efficacy profile for the treatment of F- and NF-PanNETs. EUS-RFA could be of-fered as possible alternative to surgery for the treatment of low-grade NF- or F-PanNETs, especially for those patients that are not eligible or are at high-risk for surgery.
: 专门的内镜和内镜超声（EUS）技术的发展使人们能够直接针对胰腺肿瘤性病变进行诊断和治疗。其中较有前途的目标之一是胰腺神经内分泌肿瘤（PanNETs）。 : 描述内镜超声引导下射频消融（EUS-RFA）的演变，特别关注 PanNETs 的治疗，重点介绍该技术的安全性和临床疗效。 : 在 MEDLINE、Scopus 和 Cochrane Library 数据库中搜索了关于 EUS-RFA 治疗 PanNETs 的研究。选择了有相关结果的研究，并报告了结果，以描述临床成功率、并发症、随访情况和使用的电极。临床成功率定义为功能性（F-）PanNETs 的临床症状消失和非功能性（NF-）PanNETs 的完全消融。使用随机效应模型对汇总数据进行分析。 : 共选择了 19 项研究，包括 183 名患者（82 名男性，44.8%）和 196 个病灶（101 个 F-PanNETs 和 95 个 NF-PanNETs）。汇总的总体不良事件发生率为 F-PanNETs 的 17.8%（95%CI9.1-26.4%）和 95.1%（95%CI91.2-98.9%），NF-PanNETs 的 24.6%（95%CI7.4-41.8%）和 93.4%（95%CI88.4-98.4%）。 : EUS-RFA 似乎是一种微创技术，具有良好的安全性和疗效，可用于治疗 F-和 NF-PanNETs。EUS-RFA 可以作为手术治疗低级别 NF-或 F-PanNETs 的替代方法，特别是对于那些不符合手术条件或手术风险较高的患者。
