内镜黏膜下剥离术与外科手术治疗早期结直肠癌的Meta分析

Meta-analysis of the Efficacy and Safety of ESD and Surgical Treatment for Early Colorectal Cancer

早期结直肠癌(CRC)以外科手术切除及内镜黏膜下剥离术(ESD)两种治疗方法为主,但其获益及相关风险目前仍不清楚.为评估两种治疗方案的安全性和有效性,通过检索1998年2月-2018年2月发表在Pubmed、Embase、Central、Cochrane Library、中国知网数据库、万方数据库及维普数据库的相关研究,根据所拟定的纳入标准和排除标准筛选文献,对纳入文献进行质量评价,并采用Revman5.3进行Meta分析.结果表明,ESD组在根治性切除率及整块切除率上稍低于外科手术组,但其并发症发生率及复发率无明显差异,且其更微创,手术时间及住院天数方面优于外科手术,是治疗CRC的一种安全有效的方法.

Surgery and endoscopic submucosal dissection(ESD) are two common treatments for early colorectal cancer(CRC), but their benefits and associated risks are still unclear. This study aimed to compare the differences in the efficacy and safety of the two methods in the treatment of CRC. All English and Chinese literatures on the comparison of surgical and ESD-treated CRC published in Pubmed, Embase, Central, Cochrane Library, CNKI, CQVIP and Wanfang database from February 1998 to February 2018 were searched. The searched literature was screened according to the inclusion and exclusion criteria, and the final literature was evaluated for quality. Meta-analysis was performed using Revman5.3 software. For the treatment of CRC, although the ESD group was lower than the surgical group in the whole resection rate and radical resection rate, there was no significant difference in recurrence rate and complication rate, and it was more minimally invasive and postoperative recovery faster, shorter operation time and hospital day than surgery, ESD is a safe and effective way to treat CRC.