内镜黏膜下剥离术
医学
止血
系统回顾
荟萃分析
外科
梅德林
内科学
政治学
法学
作者
Youli Chen,Xinyan Zhao,Dongke Wang,Xinghuang Liu,Jie Chen,Jun Song,Tao Bai,Xiaohua Hou
出处
期刊:Polymers
[MDPI AG]
日期:2022-06-13
卷期号:14 (12): 2387-2387
被引量:5
标识
DOI:10.3390/polym14122387
摘要
New endoscopic approaches for the prevention of delayed bleeding (DB) after gastric endoscopic submucosal dissection (ESD) have been reported in recent years, and endoscopic delivery of biodegradable polymers for iatrogenic ulcer hemostasis and coverage has emerged as one of the most promising techniques for post-ESD management. However, the comparative efficacy of these techniques remains uncertain. We performed a systematic search of multiple databases up to May 2022 to identify studies reporting DB rates as outcomes in patients undergoing gastric ESD who were treated with subsequent endoscopic management, including endoscopic closure (clip-based methods and suturing), PGA sheet tissue shielding, and hemostatic powder/gel spray (including polymeric sealants and other adhesives). The risk ratios (RRs) of delayed bleeding in treatment groups and control groups were pooled, and the Bayesian framework was used to perform a network meta-analysis (NMA). Among these studies, 16 head-to-head comparisons that covered 2742 lesions were included in the NMA. Tissue shielding using PGA sheets significantly reduced the risk of DB by nearly two thirds in high-risk patients, while hemostatic spray systems, primarily polymer-based, reduced DB in low-risk patients nine-fold. Researchers should recognize the essential role of polymers in the management of ESD-induced ulcers, and develop and validate clinical application strategies for promising materials.
科研通智能强力驱动
Strongly Powered by AbleSci AI