Transanal endoscopic microsurgery versus traditional transanal excision for rectal neoplasms:systematic review

Wang Tao; Fei Jiandong; Nie Shuangfa; Wu Xueliang; Xue Jun

doi:10.13406/j.cnki.cyxb.000869

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Transanal endoscopic microsurgery versus traditional transanal excision for rectal neoplasms:systematic review

更新时间：2024-01-17

- Transanal endoscopic microsurgery versus traditional transanal excision for rectal neoplasms:systematic review
- Journal of Chongqing Medical University Vol. 41, Issue 3, Pages: 307-310(2016)
- 作者机构：
  
  河北北方学院附属第一医院普外科
- 作者简介：
- 基金信息：
- DOI：10.13406/j.cnki.cyxb.000869
  CLC： R735.37
- Published：2016，
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[1]王韬,费建东,聂双发,武雪亮,薛军.经肛门内镜微创手术与标准经肛门局切术对直肠肿瘤疗效及安全性比较的系统评价[J].重庆医科大学学报,2016,41(03):307-310.

Wang Tao, Fei Jiandong, Nie Shuangfa, et al. Transanal endoscopic microsurgery versus traditional transanal excision for rectal neoplasms:systematic review. [J]. Journal of Chongqing Medical University 41(3):307-310(2016)
[1]王韬,费建东,聂双发,武雪亮,薛军.经肛门内镜微创手术与标准经肛门局切术对直肠肿瘤疗效及安全性比较的系统评价[J].重庆医科大学学报,2016,41(03):307-310. DOI： 10.13406/j.cnki.cyxb.000869.

Wang Tao, Fei Jiandong, Nie Shuangfa, et al. Transanal endoscopic microsurgery versus traditional transanal excision for rectal neoplasms:systematic review. [J]. Journal of Chongqing Medical University 41(3):307-310(2016) DOI： 10.13406/j.cnki.cyxb.000869.

摘要

目的:比较肛门内镜微创手术和标准经肛门局切术治疗直肠肿瘤的疗效及安全性。方法:检索Pubmed、Embase、The Cochrane Library和中国期刊全文数据库及万方数据库中1990至2015年比较肛门内镜微创手术和标准经肛门局切术治疗直肠肿瘤的随机对照试验或对照试验。使用Rev Man 5.3软件对术后并发症发生率、切缘阴性率、样本破碎率及复发率进行meta分析。结果:共6篇文献927例患者入选研究

其中肛门内镜微创手术组492例

标准经肛门局切术组435例。分析显示肛门内镜微创手术组与标准经肛门局切术组术后并发症发生率（RR=0.92

95%CI=0.65

.31

P=0.660）的差异无统计学意义。肛门内镜微创手术组切缘阴性率高于标准经肛门局切术组（RR=1.30

95%CI=1.06

.58

P=0.010）。肛门内镜微创手术组样本破碎率（RR=0.16

95%CI=0.08

.29

P=0.000）及复发率（RR=0.32

95%CI=0.22

.46

P=0.000）低于标准经肛门局切术组。结论:肛门内镜微创手术作为一项安全、有效的手术方式

在提高切缘阴性率、降低样本破碎率及复发率方面优于标准经肛门局切术。

Abstract

Objective:To compare the efficacy and safety of transanal endoscopic microsurgery(TEM)and traditional transanal excision(TAE)for rectal neoplasms. Methods:Randomized controlled trials(RCTs)or comparative studies comparing TEM with TAE for rectal neoplasms published from 1990 to 2015 were searched in Pubmed

Embase

The Cochrane Library and China National Knowledge Infrastructure(CNKI)

Wanfang Data. Review manager 5.3 was used for Meta-analysis and postoperative complication rate

negative microscopic margins

specimen fragmentation and lesion recurrence were analyzed and compared. Results:A total of 6 studies including 927 patients were identified and analyzed. The results showed no significant difference in the postoperative complication rate(RR=0.92

95%CI=0.65 to 1.31

P=0.660). The rate of negative microscopic margins was higher in TEM(RR=1.30

95%CI=1.06 to1.58

P=0.010). However

specimen fragmentation(RR=0.16

95%CI=0.08 to 0.29

P=0.000)and lesion recurrence(RR=0.32

95%CI=0.22 to 0.46

P=0.000)were more frequently observed in TAE group. Conclusion:TEM is superior to TAE in increasing negative microscopic margins and reducing specimen fragmentation and lesion recurrence.

关键词

肛门内镜微创手术传统经肛门局切术直肠肿瘤Meta分析系统评价

Keywords

transanal endoscopic microsurgerytraditional transanal excisionrectal neoplasmsMeta analysissystematic review

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Related Institution

Institute of Gastroenterology,Southwest Hospital,Third Military Medical University

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Institute of Gastroenterology of PLA，Southwest Hospital，Third Military Medical University

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