Prophylactic Clipping to Prevent Delayed Bleeding and Perforation After Endoscopic Submucosal Dissection and Endoscopic Mucosal Resection
Prophylactic Clipping to Prevent Delayed Bleeding and Perforation After Endoscopic Submucosal Dissection and Endoscopic Mucosal Resection
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预防性夹闭以防止内镜粘膜下剥离术和内镜粘膜切除术后迟发性出血和穿孔
DOI：
10.1097/mcg.0000000000001721
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发表时间：
2022
影响因子：
2.9
通讯作者：
Dong Li
中科院分区：
文献类型：
--
作者：
Wenxi Jiang;Li Cen;C. Dong;Shefeng Zhu;Zhe Shen;Dong Li
背景：为了防止内窥镜手术后的延迟不良事件，内窥镜psists通常将剪辑放在现场。该荟萃分析旨在评估预防预防延迟出血和穿孔的效率和安全性。 1。我们包括所有相关的研究比较了预防性剪辑组与非prophastic剪切组的剪辑组的结果：二十七个文章满足了纳入标准。 ％置信区间： 0.25-0.49，p <0.01：0.42，95％的置信区间：0.21-0.83，p <0.05。与EMR相比，与D相关的延迟不良事件。结论：ESD和EMR后的预防性剪辑有益于防止延迟出血和穿孔。
Background and Aims: To help prevent delayed adverse events after endoscopic surgery, endoscopists often place clips at the site. This meta-analysis aimed to assess the efficacy and safety of prophylactic clipping in the prevention of delayed bleeding and perforation after endoscopic submucosal dissection (ESD) and endoscopic mucosal resection (EMR). Methods: Multiple databases were searched from the inception dates to April 2021. And we included all relevant studies. Pooled odds ratio comparing the prophylactic clipped group versus nonprophylactic clipped group were calculated using the random effects model. Results: Twenty-seven articles fulfilled the inclusion criteria, with a total size of 8693 participants. There was statistically significant difference in prophylactic clipping versus no prophylactic clipping for delayed bleeding and perforation found in all studies (odds ratio: 0.35, 95% confidence interval: 0.25-0.49, P<0.01; odds ratio: 0.42, 95% confidence interval: 0.21-0.83, P<0.05; respectively). Besides, statistically significant difference was also found in subgroup analyses based on patients with lesions larger than 20 mm. Prophylactic clipping was more protective for duodenal delayed adverse events than colorectum. The use of clip closure was more protective to ESD-related delayed adverse events than EMR. Conclusions: Prophylactic clipping after ESD and EMR was beneficial in preventing delayed bleeding and perforation.