Meta-analysis of endoscopic mucosal resection with ligation device and endoscopic submucosal dissection in treatment of rectal neuroendocrine neoplasm ( ≤ 10 mm)
- VernacularTitle:带结扎装置的内镜下黏膜切除术与内镜黏膜下剥离术治疗直肠神经内分泌肿瘤(≤10 mm)疗效的Meta分析
- Author:
Xu WANG
1
;
Yongchun FU
1
;
Jinchun ZHANG
1
Author Information
- Publication Type:Journal Article
- Keywords: endoscopic mucosal resection with ligation device (EMR-L); endoscopic submucosal dissection (ESD); rectal neuroendocrine neoplasm (rNEN); efficacy; safety; Meta-analysis
- From: China Journal of Endoscopy 2024;30(12):43-54
- CountryChina
- Language:Chinese
- Abstract: Objective To evaluate the safety and effectiveness of endoscopic mucosal resection with ligation device (EMR-L) and endoscopic submucosal dissection (ESD) for the rectal neuroendocrine neoplasm (rNEN) ( ≤ 10 mm).Methods Databases such as the Cochrane Library,PubMed,Embase,Web of Science,SinoMed,China National Knowledge Infrastructure,Weipu and Wanfang database were searched by computer.The retrieval time limit was December 13,2023.The literatures on the efficacy of EMR-L and ESD in treatment of rNEN patients were collected.Two researchers independently screened the literatures and extracted the data,evaluated the methodological quality by Newcastle-Ottawa Scale (NOS).The Rev Man 5.3 software was used for Meta-analysis and funnel plot,and STATA 18.0 was used for publication bias detection.Results 14 literatures were included in the study involving 1,234 patients,including 488 patients in the EMR-L group,518 patients in the ESD group and other operation types 228 cases.Meta-analysis showed that there was no significant difference in histological complete resection rate between the EMR-L group and the ESD group (O(R)=1.24,95％CI:0.54～2.86,P=0.610);The difference was not statistically significant of lesion diameter (WMD=-0.27,95％CI:-0.77～0.23,P=0.290);The operative time of EMR-L group was significantly shorter than that of ESD (WMD=-12.71,95％CI:-17.51～-7.92,P=0.000);There was no significant difference in the positive rate of horizontal and vertical margins between groups (P>0.05).There were no significant differences in the incidence of total complications,postoperative delayed bleeding and intestinal perforation among the groups (P>0.05).Conclusion Compared with ESD,the treatment of rNEN with diameter ≤ 10 mm by EMR-L is comparable effective and save more time.EMR-L is suitable for extensive using because of simple technical requirements for surgical instruments and endoscopists.
