A Meta-analysis Of Endoscopic Submucosal Dissection And Endoscopic Mucosal Resection For Early Gastric Cancer

Objective To evaluate the effectiveness and safety of endoscopic submucosal dissection(ESD) versus endoscopic mucosal resection(EMR) for early gastric cancer. so as to provide references for clinical practice and study.Methods Fifteen controlled clinical trials that met the inclusion criterion were collected from several domestic and global databases, and a Meta-analysis was performed on the data concerning resection rate, local recurrence rate, operative time, bleeding and gastric perforation of the patients selected using fixed-effects and random-effects model, respectively.Results The sesults of meta-analyses showed that:a)Efficacy evaluation:There were significant diferences between ESD group and EMR group in en bloc resection rate, complete resection rate, curative resection rate, and local recurrence rate; the OR value And 95%CI were 8.91(5.79-13.71)P<0.00001,11.33(6.94-18.49)P<0.00001, 2.95(2.12-4.11) P<0.00001,0.11(0.04-0.34) P=0.0001, respectively; b)Safety evaluation:There were significant diferences between ESD group and EMR group in perforation risk(OR=2.78,95%CI=1.74-4.43,P<0.0001) and operation time(WMD=1.52,95%CI=0.78-2.27,P<0.00001). But there were no significant differences between ESD group and EMR group in the bleeding.Conclusion Compared with EMR for early gastric cancer, ESD showed considerable advantages regarding en bloc resection rate, complete resection rate, curative resection rate,and local recurrence rate, but it had the disadvantages of higher complication rates for perforation. All of the results mentioned should be confirmed by clinical studies with high-quality.