摘要
Abstract
Objective To evaluate the risk factors of delayed bleeding after endoscopic submucosal dissection(ESD)for early gastric cancer(EGC)by Meta-analysis.Methods The articles about ESD treatment of EGC and description of delayed bleeding after the operation in PubMed,Cochrane Library,Embase,China National Knowledge Infrastructure,Wanfang Database and VIP Database were searched by computer.Newcastle-Ottawa scale(NOS)was used to evaluate the quality of the retrieved literature,and the case data of related indicators were extracted from the finally included literature.Meta-analysis was carried out by RevMan5.3 statistical software.Results A total of 14 literature were included,including 6 150 research subjects,415 cases of delayed bleeding after ESD.The results of Meta-analysis showed that lesion diameter ≥3 cm(OR=2.22,95％CI=1.78-2.76),lesion depth located in the submucosa(OR=7.60,95％CI=2.89-19.99),focus located in the middle and lower third of the stomach(OR=4.55,95％CI=2.65-7.81),significant intraoperative bleeding(OR=6.38,95％CI=2.84-14.30),age ≥ 60 years old(OR=3.14,95％ CI=1.30-7.59),preoperative biopsy times ≥ 2(OR=6.81,95％ CI=3.05-15.22),history of taking antithrombotic drugs(OR=4.65,95％ CI=2.31-9.36),submucosal fibrosis(OR=9.33,95％ CI=2.90),operation time ≥60 min(OR=2.98,95％ CI=1.60-5.57)and lesion resection diameter＞40 mm(OR=2.21,95％ CI=1.29-3.80),all of the above 10 factors are risk factors for delayed bleeding after ESD in EGC patients.Conclusion The risk factors of delayed bleeding after ESD in EGC patients are lesion diameter≥3 cm,lesion depth located in submucosa,focus located in the middle and lower third of stomach,significant intraoperative bleeding,age≥60 years old,preoperative biopsy times≥2 times,history of taking antithrombotic drugs,submucosal fibrosis,operation time ≥60 min and lesion resection diameter＞40 mm,which should be prevented according to relevant risk factors.关键词
早期胃癌/内镜黏膜下剥离术/迟发性出血/危险因素/Meta分析Key words
Early gastric cancer/Endoscopic submucosal dissection/Delayed bleeding/Risk factor/Meta-analysis分类
医药卫生
