EUS-guided gastroenterostomy for gastric outlet obstruction: a comprehensive meta-analysis.

IF 1.7 4区医学 Q2 SURGERY Minimally Invasive Therapy & Allied Technologies Pub Date : 2023-12-01 Epub Date: 2023-06-13 DOI:10.1080/13645706.2023.2221336

Jia-Su Li, Kun Lin, Jian Tang, Feng Liu, Jun Fang

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引用次数: 0

Abstract

Objective: 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).

Material and methods: 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).

Results: 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 (p = .003), 1.42 (p = .40), and 0.15 (p < .00001), respectively. When compared with ES, the above corresponding pooled ORs were 0.55 (p = .11), 2.64 (p < .0001), and 0.41 (p = .01), respectively.

Conclusion: 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.

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EUS引导下的胃肠造口术治疗胃出口梗阻：一项综合荟萃分析。

目的：对内镜超声引导下胃肠造口术（EUS-GE）治疗良性和恶性胃出口梗阻（GOO）的有效性和安全性进行综合荟萃分析：检索了 PubMed、Embase、Web of Science 和 Cochrane Library，以确定相关研究。主要结果评估了技术成功率、临床成功率和不良事件（AEs）：本次荟萃分析共纳入26项研究，1493名患者。EUS-GE的技术成功率、临床成功率和总体AEs汇总率分别为94.0%、89.9%和13.1%。亚组荟萃分析纳入了 8 项研究，对 EUS-GE 和外科胃肠造口术（SGE）进行了比较评估，7 项研究涉及 EUS-GE 和肠道支架术（ES）。与 SGE 相比，EUS-GE 的技术成功率、临床成功率和总体 AEs 的汇总赔率（ORs）分别为 0.17（p = .003）、1.42（p = .40）和 0.15（p < .00001）。与 ES 相比，上述相应的集合 OR 分别为 0.55 (p = .11)、2.64 (p < .0001) 和 0.41 (p=.01)：尽管在技术上具有挑战性，但这项最大规模的荟萃分析表明，EUS-GE 具有相当高的技术和临床成功率，因此是治疗 GOO 的一种非常有效的微创手术。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Minimally Invasive Therapy & Allied Technologies 医学-外科

CiteScore

3.80

自引率

5.90%

发文量

审稿时长

6-12 weeks

期刊介绍： Minimally Invasive Therapy and Allied Technologies (MITAT) is an international forum for endoscopic surgeons, interventional radiologists and industrial instrument manufacturers. It is the official journal of the Society for Medical Innovation and Technology (SMIT) whose membership includes representatives from a broad spectrum of medical specialities, instrument manufacturing and research. The journal brings the latest developments and innovations in minimally invasive therapy to its readers. What makes Minimally Invasive Therapy and Allied Technologies unique is that we publish one or two special issues each year, which are devoted to a specific theme. Key topics covered by the journal include: interventional radiology, endoscopic surgery, imaging technology, manipulators and robotics for surgery and education and training for MIS.