内镜黏膜下剥离术治疗非肌层浸润性膀胱肿瘤疗效单组率的Meta分析

Efficacy and safety of transurethral endoscopic submucosal dissection for non-muscle invasive bladder cancer:a single-arm meta analysis

目的系统评价经尿道内镜黏膜下剥离术(BT-ESD)治疗非肌层浸润性膀胱肿瘤(NMIBC)的有效性和安全性。方法计算机检索PubMed、Cochrane Library、SciVerse、Embase、中国知网、维普及万方数据库,检索时间从建库至2018年12月。收集采用BT-ESD治疗NMIBC的单臂临床研究。由2位研究者独立筛选文献,应用RevMan 5.3软件进行Meta分析。结果共纳入5个研究,包含156例患者。Meta分析结果显示,BT-ESD治疗NMIBC其肿瘤完整切除率为75%(95% CI:0.70~0.80,P<0.0000);BT-ESD治疗NMIBC并发症发生率为44%(95% CI:0.32~0.57,P=0.3500)。结论当前证据表明BT-ESD治疗NMIBC具有较高的肿瘤完整切除率,而在减少术中并发症方面其并无优势可言,但仍不失为一种治疗NMIBC的有效方式。

Objective To systematically assess the efficacy and safety of transurethral bladder tumor endoscopic submucosal dissection (BT-ESD) for non-muscle invasive bladder cancer (NMIBC). Methods Non-comparative binary data on BT-ESD for NMIBC from PubMed, Cochrane Library, SciVerse, Embase, CNKI, VIP and Wanfang database were collected from databases establishment to Dec. 2018. Two reviewers independently screened the trials, and conducted the meta-analysis with RevMan 5.3 soft ware. Results A total of 5 trials were eligible for the study including 156 cases. The pooled results showed that the rate of en bloc resection was 75%(95% CI :0.70-0.80, P <0.000 0), and the rate of adverse events of BT-ESD for NMIBC was 44%(95% CI :0.32-0.57, P =0.350 0). Conclusions Current evidence showed that BT-ESD had a high rate of en bloc resection. Althiugh, BT-ESD did not have an advantage over complications, it was a good choice for NMIBC.