Department of Gastroenterology, Zhongnan Hospital of Wuhan University, Wuhan, China.
Digestive Endoscopy Center, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China.
Minim Invasive Ther Allied Technol. 2023 Dec;32(6):285-299. doi: 10.1080/13645706.2023.2221336. Epub 2023 Jun 13.
A comprehensive meta-analysis was performed to evaluate the efficacy and safety of endoscopic ultrasound-guided gastroenterostomy (EUS-GE) for benign and malignant gastric outlet obstruction (GOO).
PubMed, Embase, Web of Science and Cochrane Library were searched to identify relevant studies. The primary outcomes evaluated technical success, clinical success, and adverse events (AEs).
Twenty‑six studies with 1493 patients were included in this meta-analysis. The pooled rates of technical success, clinical success, and overall AEs of EUS-GE were 94.0%, 89.9%, and 13.1%, respectively. Eight studies were included in the subgroup meta-analysis for comparative evaluation of EUS-GE and surgical gastroenterostomy (SGE), while seven studies were for EUS-GE and enteral stenting (ES). Compared with SGE, the pooled odds ratios (ORs) of technical success, clinical success, and overall AEs of EUS-GE were 0.17 ( = .003), 1.42 ( = .40), and 0.15 ( < .00001), respectively. When compared with ES, the above corresponding pooled ORs were 0.55 ( = .11), 2.64 ( < .0001), and 0.41 ( = .01), respectively.
Although it is technically challenging, this largest meta-analysis indicates that EUS‑GE has comparable and high technical and clinical success rates and hence a very effective minimally invasive procedure for GOO.
进行全面的荟萃分析，以评估内镜超声引导下胃造口术（EUS-GE）治疗良性和恶性胃出口梗阻（GOO）的疗效和安全性。
检索 PubMed、Embase、Web of Science 和 Cochrane Library 以确定相关研究。主要结局评估技术成功率、临床成功率和不良事件（AEs）。
这项荟萃分析纳入了 26 项研究，共 1493 名患者。EUS-GE 的技术成功率、临床成功率和总体 AEs 发生率分别为 94.0%、89.9%和 13.1%。8 项研究纳入了 EUS-GE 与手术胃造口术（SGE）的亚组荟萃分析，7 项研究纳入了 EUS-GE 与肠内支架置入术（ES）的比较评估。与 SGE 相比，EUS-GE 的技术成功率、临床成功率和总体 AEs 的合并比值比（ORs）分别为 0.17（ =.003）、1.42（ =.40）和 0.15（ <.00001）。与 ES 相比，上述相应的合并 ORs 分别为 0.55（ =.11）、2.64（ <.0001）和 0.41（ =.01）。
尽管技术上具有挑战性，但这项最大的荟萃分析表明，EUS-GE 具有相当高的技术和临床成功率，是一种非常有效的治疗 GOO 的微创方法。
