A Meta-analysis Of ESD And EMR For The Treatment Of Early Gastric Cancer About Curative Effect And Complications

Purpose:Comparing the curative effect and security of the EMR and ESD for treatment of early gastric cancer,to provide clinical reference for reasonable selection of treatment of early gastric cancer.Methods:Making the corresponding retrieval strategy and comprehensive computer retrieval and manual retrieval,to get literature on the basis of exclusion and inclusion criteria,then evaluating the quality of literature,to access to relevant data and analysis by using Meta Rev Man5software. Results:(1).Eleven studies were identified (9full text and2abstracts).A total of4327lesions were enrolled (ESD1983; EMR2344).(2).The mean time required for resection was longer for ESD than for EMR(weighted mean difference61.38;95%confidence interval [CI],16.54-106.22).the en bloc rate in the ESD group was significantly higher than that in the EMR group (OR8.95;95%CI,5.93-13.49),and so was the total histologically complete resection rate (OR5.43;95%CI,3.03-9.73).The ESD group had lower recurrence frequency (OR0.12;95%CI,0.07-0.22).(3)The perforation rate was higher in the ESD group (OR2.89;95%CI,1.19-7.02),whereas the bleeding incidences were similar between the two groups (OR1.30;95%CI,0.80-2.00).Conclusion:Compared with EMR for early gastric cancer,ESD showed considerable advantages regarding enbloc resection rate, histologically complete resection rate, and local recurrence even for small lesions,but it had the disadvantages of higher complication rates for perforation. This may limit the application of ESD in the smaller diameter of early gastric cancer All of the results mentioned should be confirmed by well-designed,randomized,controlled trials from more countries,with larger samples and long enough follow-up periods.