Chen De-Yi, Chen Hai-Dong, Lv Xiao-Dan, Huang Zhou, Jiang Dan, Li Yu, Han Bing, Han Li-Chun, Xu Xiao-Fang, Li Shi-Quan, Lin Guang-Fu, Huang Zhi-Xi, Lin Jia-Ning, Lv Xiao-Ping
Department of Gastroenterology, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi Zhuang Autonomous Region, China.
Department of Gastroenterology, The Tenth Affiliated Hospital of Guangxi Medical University, Qinzhou 535000, Guangxi Zhuang Autonomous Region, China.
World J Gastrointest Surg. 2024 Nov 27;16(11):3568-3577. doi: 10.4240/wjgs.v16.i11.3568.
Endoscopic submucosal dissection (ESD) is widely utilized for the treatment of large adenomas, submucosal lesions, and early gastric cancer. A significant artificial ulcer typically forms after ESD. Delayed or incomplete healing of these ulcers can result in complications such as delayed bleeding and perforation. However, a comprehensive review of the outcomes and risk factors related to ulcer healing following ESD is currently lacking.
To assess ulcer healing outcomes and identify risk factors associated with delayed ulcer healing.
Databases retrieved by computer include PubMed, EMBASE, The Cochrane Library, Web of Science, China National Knowledge Infrastructure, Wan Fang Data, and VIP. The study collects reports on ESD post-surgical ulcer healing outcomes and risk factors, using Stata 16.0 and RevMan 5.0 software for meta-analysis.
Our analysis included 12 studies, involving a total of 3430 patients. The meta-analysis revealed an overall healing rate of 65.55% for ulcers following ESD [odds ratio (OR) = 2.71; 95% confidence interval (CI): 2.45-3.00]. The healing rate within eight weeks was 48.32% (OR = 0.76; 95%CI: 0.35-1.66), while the rate beyond eight weeks was 88.32% (OR = 6.73; 95%CI: 3.82-11.87). Risk factors included () infection (OR: = 5.32; 95%CI: 1.90-14.87; = 0.001), ulcer size (OR = 2.08; 95%CI: 1.19-3.61; = 0.01), lesion site (OR = 2.08; 95%CI: 1.19-3.11), and pathological type (OR = 1.64; 95%CI: 1.06-2.52). Diabetes (OR = 0.56; 95%CI: 0.05-5.80; = 0.63) and duration of operation (OR = 1.00; 95%CI: 0.99-1.01; = 0.96) were not significant factors.
The healing rate of ulcers following ESD is high after eight weeks. Risk factors affecting the healing process include infection, ulcer size, lesion site, and pathological type.
内镜黏膜下剥离术（ESD）广泛应用于治疗大型腺瘤、黏膜下病变和早期胃癌。ESD术后通常会形成明显的人工溃疡。这些溃疡延迟愈合或愈合不完全可导致诸如延迟出血和穿孔等并发症。然而，目前缺乏对ESD术后溃疡愈合相关结局和危险因素的全面综述。
评估溃疡愈合结局并确定与溃疡延迟愈合相关的危险因素。
通过计算机检索的数据库包括PubMed、EMBASE、Cochrane图书馆、科学网、中国知网、万方数据和维普资讯。本研究收集关于ESD术后溃疡愈合结局和危险因素的报告，使用Stata 16.0和RevMan 5.0软件进行荟萃分析。
我们的分析纳入了12项研究，共涉及3430例患者。荟萃分析显示ESD术后溃疡的总体愈合率为65.55%[比值比（OR）=2.71；95%置信区间（CI）：2.45 - 3.00]。8周内的愈合率为48.32%（OR = 0.76；95%CI：0.35 - 1.66），而8周后的愈合率为88.32%（OR = 6.73；95%CI：3.82 - 11.87）。危险因素包括（）感染（OR = 5.32；95%CI：1.90 - 14.87；P = 0.001）、溃疡大小（OR = 2.
