eISSN: 2299-0054
ISSN: 1895-4588
Videosurgery and Other Miniinvasive Techniques
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2/2024
vol. 19
 
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abstract:
Meta-analysis

Meta-analysis of clinical efficacy and safety of transanal endoscopic microsurgery and endoscopic submucosal dissection in the treatment of rectal tumors

Jin Yao
1
,
Yongshen Fan
1

  1. Proctology Department, Zhejiang Hospital, Hangzhou, China
Videosurgery Miniinv 2024; 19 (2): 152–159
Online publish date: 2024/05/27
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Aim
The aim of the article was to systematically evaluate the clinical efficacy and safety of transanal endoscopic microsurgery (TEM) and endoscopic submucosal dissection (ESD) in the treatment of rectal tumors.

Material and methods
Control studies were conducted on cases included in the electronic databases Medline, Embase, Cochrane Library, and CNKI. Patients with colorectal tumors were included in the TEM and ESD groups for treatment, with the main indicators being R0 resection rate, postoperative perforation and bleeding incidence, and tumor recurrence rate. The meta-analysis was carried out using RevMan 5.3 software.

Results
A total of 10 studies were included, with 736 patients. The analysis showed that for the recurrence rate in the TEM group compared to ESD, OR = 1.23, 95% CI = 0.56–2.72, p = 0.60; for the R0 resection rate between the TEM group and ESD group, OR = 1.35, 95% CI = 0.82–2.22, p = 0.24; for the incidence of perforation in the TEM and ESD groups, OR = 0.59, 95% CI = 0.25–1.40, p = 0.23. The inter-group comparison of these three items was statistically significant. Compared with the ESD group, the hospitalization time and the incidence of bleeding of the TEM group were both lower, with SD = 0.48, 95% CI = 0.26–0.69, p < 0.001 and OR = 0.35, 95% CI = 0.13–0.92, p = 0.03. The differences were statistically significant.

Conclusions
Both TEM and ESD endoscopic treatment techniques can achieve a higher R0 resection rate and lower risk of tumor recurrence in the treatment of colorectal tumors. However, TEM may have higher surgical safety than ESD technology, and can shorten postoperative hospitalization time and lower postoperative bleeding rate.

keywords:

transanal endoscopic microsurgery, endoscopic submucosal dissection, rectal tumors, efficacy, security

  
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