摘要
目的利用meta分析评估内镜黏膜下剥离术(ESD)治疗早期结直肠癌(CRC)及癌前病变术后迟发性出血的危险因素。方法系统检索国内外中、英文文献,提取与ESD治疗早期CRC及癌前病变术后迟发性出血相关指标的病例数据,通过计算OR值及95%CI进行meta分析。结果共有35篇原始研究纳入meta分析,结果显示有5个指标与术后出血的发生风险显著相关,分别为高血压合并症(P=0.036,OR=1.43)、肿瘤位置(直肠vs.结肠:P<0.001,OR=3.40)、肿瘤大小(≥4cm vs.<4cm:P=0.035,OR=3.27)、病理分型(P=0.010,OR=1.59)以及纤维化(P<0.001,OR=3.56)。结论合并高血压病史以及体积较大、病理较恶性且伴有严重黏膜纤维化的直肠肿瘤可能是ESD治疗早期CRC及癌前病变术后迟发性出血的显著危险因素。
Objective To evaluate the risk factors of delayed bleeding for early colorectal cancer(CRC) and precancerous lesion after endoscopic submucosal dissection(ESD) by means of meta-analysis. Methods The case data of indicators related to delayed bleeding after ESD for early CRC and precancerous lesion were extracted from 35 literatures. And meta-analysis was performed by calculating OR value and 95% CI. Results A total of 35 original articles were involved in the meta-analysis. 5 indicators were significantly associated with the risk of postoperative bleeding, including hypertension(P=0.036, OR=1.43), tumor location(rectum vs. colon: P<0.001, OR=3.40), tumor size(≥ 4 cm vs.<4 cm: P=0.035, OR=3.27), histopathological type(P=0.010, OR=1.59) and fibrosis(P<0.001, OR=3.56). Conclusion History of hypertension and rectal tumor with large size, malignant type and severe mucosal fibrosis were significant risk factors of delayed bleeding after ESD for early CRC and precancerous lesion.
作者
吕执
郑博文
邢承忠
LV Zhi;ZHENG Bo-wen;XING Cheng-zhong(Department of Anorectal Surgery,the First Hospital,China Medical University,Shenyang 110001,China)
出处
《解剖科学进展》
CAS
2021年第4期458-461,共4页
Progress of Anatomical Sciences
基金
辽宁省自然科学基金指导计划(2019-ZD-0748)。
