Hemorrhage?prevention value of second?look endoscopy after endoscopic submucosal dissection for early gastric cancer: a meta?analysis
10.3760/cma.j.issn.1671?0274.2019.07.013
- VernacularTitle:早期胃癌内镜黏膜下剥离术后二次内镜检查对于出血预防意义的Meta分析
- Author:
Jingjing LIAN
1
;
Shiyao CHEN
;
Pinghong ZHOU
;
Yiqun ZHANG
Author Information
1. 复旦大学附属中山医院内镜中心
- Keywords:
Second?look endoscopy;
Endoscopic submucosal dissection;
Meta?analysis
- From:
Chinese Journal of Gastrointestinal Surgery
2019;22(7):673-677
- CountryChina
- Language:Chinese
-
Abstract:
Objective To use the meta?analysis in evaluating the hemorrhage?prevention value of second?look endoscopy after endoscopic submucosal dissection (ESD) for early gastric cancer. Methods A literature search was conducted to identify all relevant studies comparing second?look endoscopy and non?second?look endoscopy after gastric ESD. The Medline/PubMed, Ovid, Elsevier ScienceDirect, EBSCO, CNKI and VIP databases were searched systematically. Literature inclusion criteria: (1) all the patients were diagnosed as early gastric cancer receiving ESD; (2) end point of the study included postoperative bleeding rate of ESD. Exclusion criteria: (1) papers of repeated research, review, comment, guideline, etc; (2) non?control study. Meta?analysis method was used to calculate a pooled odds ratio (OR) for developing post?ESD bleeding. Results The meta?analysis showed that post?ESD bleeding was observed in 40 of 1287 patients (3.1%) without second?look endoscopy and in 40 of 968 patients (4.1%) with second?look endoscopy (OR=1.25, 95% CI: 0.79?1.98), with no significant difference between these two groups. Subgroup analysis on research method still indicated no significant difference of post?ESD bleeding between RCT group (OR=1.45,95%CI: 0.79?2.65) and non?RCT group (OR=1.02, 95%CI:0.50?2.08) (all P>0.05). Conclusion Based on meta analysis, second?look endoscopy can not reduce the rate of postoperative bleeding of ESD. Therefore, routine second?look endoscopy after gastric ESD may not be necessary to prevent delayed postoperative bleeding of ESD.
