经内镜超声引导胆道和胆囊引流用各种防反流金属支架的间接比较：系统评价和荟萃分析。
Indirect comparison of various lumen-apposing metal stents for EUS-guided biliary and gallbladder drainage: a systematic review and meta-analysis.
机构信息
Internal Medicine, Sinai Hospital of Baltimore, Baltimore, Maryland, USA.
Gastroenterology and Hepatology, State University of New York Upstate Medical University, Syracuse, New York, New York, USA.
出版信息
Gastrointest Endosc. 2024 Nov;100(5):829-839.e3. doi: 10.1016/j.gie.2024.05.024. Epub 2024 Jun 6.
BACKGROUND AND AIMS
Studies assessing EUS-guided biliary drainage (EUS-BD) or gallbladder drainage (EUS-GB) using lumen-apposing metal stents (LAMSs) have shown variable results based on the type of LAMS. We performed a meta-analysis of the available data.
METHODS
Multiple online databases were searched for studies using LAMSs (Axios [Boston Scientific, Marlborough, Mass, USA] or Spaxus [Taewoong Medical Co, Gimpo, Korea]) for EUS-BD and EUS-GB. The outcomes of interest were technical success, clinical success, and adverse events. Pooled proportions along with 95% confidence intervals were calculated.
RESULTS
A total of 18 observational studies were included: 11 for the Axios stent (433 patients; mean age, 72 years; 54% male) and 7 for the Spaxus stent (242 patients; mean age, 74 years; 50% male). The respective pooled outcomes for the Axios stent (EUS-BD and EUS-GB, respectively) were technical success, 96.2% and 96.2%; clinical success, 92.8% and 92.7%; total adverse events, 10.1% and 23.6%; and bleeding, 3.7% and 4.8%. The respective pooled outcomes for the Spaxus stent (EUS-BD and EUS-GB, respectively) were technical success, 93.8% and 95.9%; clinical success, 90.1% and 94.2%; total adverse events, 12.6% and 9.5%; and bleeding, 3.1% and 1.8%.
CONCLUSIONS
Axios and Spaxus stents demonstrate similar pooled technical and clinical success rates. Adverse events occurred in 23.6% of patients (Axios stent) and 9.5% of patients (Spaxus stent) during EUS-GB.
背景与目的
使用 lumen-apposing 金属支架（LAMS）评估超声内镜引导下胆道引流（EUS-BD）或胆囊引流（EUS-GB）的研究结果因 LAMS 类型而异。我们对现有数据进行了荟萃分析。
方法
在多个在线数据库中搜索使用 LAMS（Axios [波士顿科学公司，马萨诸塞州马尔伯勒] 或 Spaxus [Taewoong Medical Co，韩国金浦]）进行 EUS-BD 和 EUS-GB 的研究。主要结局指标为技术成功率、临床成功率和不良事件。计算了合并比例及其 95%置信区间。
结果
共纳入 18 项观察性研究：Axios 支架 11 项（433 例患者；平均年龄 72 岁；54%为男性），Spaxus 支架 7 项（242 例患者；平均年龄 74 岁；50%为男性）。Axios 支架（EUS-BD 和 EUS-GB）的各自汇总结局为技术成功率分别为 96.2%和 96.2%；临床成功率分别为 92.8%和 92.7%；总不良事件发生率分别为 10.1%和 23.6%；出血发生率分别为 3.7%和 4.8%。Spaxus 支架（EUS-BD 和 EUS-GB）的各自汇总结局为技术成功率分别为 93.8%和 95.9%；临床成功率分别为 90.1%和 94.2%；总不良事件发生率分别为 12.6%和 9.5%；出血发生率分别为 3.1%和 1.8%。
结论
Axios 和 Spaxus 支架的汇总技术和临床成功率相似。在 EUS-GB 中，12.6%的患者（Spaxus 支架）和 23.6%的患者（Axios 支架）发生不良事件。
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