| Objective:There are two options for surgical treatment and endoscopic submucosal dissection(ESD)in early treatment of gastric cancer.Now compare the effectiveness and safety of two different treatments.Contrast outcomes included: operative time,fasting and water-free time,hospital stay,gastrointestinal decompression time,hospitalization costs,total complication rate,and recurrence rate.Methods:PubMed,Embase,Cochran Library,CNKI and Wanfang databases were retrieved to collect all published literature before 2019-Randomized Controlled Trials(RCTs)to compare surgical procedures(including traditional open and laparoscopic)and endoscopic submucosal dissection.After screening the literature according to the strict inclusion criteria,the quality was evaluated according to the Newcastle-Ottawa Scale(NOS)literature quality evaluation scale,and the valid data was extracted.The collected data were systematically evaluated using RevMan5.3 software.Results:There is a total of 14 RCTs which enrolling 6139 patients,of these,2078 were in the surgery group and 4061 were in the ESD group.Meta analysis: Compared with the surgical group,the operation time of patients in the ESD group(SMD=-3.13,95% CI:-3.42--2.84,P<0.00001),fasting water time(SMD=-2.36,95% CI:-3.71--1.00,P=0.0006)and short hospital stay(MD=-6.59,95% IC-6.96--6.21,P=0.0000),the risk of postoperative total complications was low(OR=0.36,95% CI: 0.24-0.54;P<0.00001),and the 5-year postoperative survival rate was high(RR=1.02,95% CI: 1.01—1.03).;P=0.006).However,there was an advantage in the complete resection rate of tumor(OR=0.12,95% CI: 0.04-0.39;P=0.0004)and control of postoperative recurrence rate(OR=3.18,95% CI: 1.27-7.96;P=0.01).Conclusious:For East Asians: For East Asians,surgical treatment of early gastric cancer is superior to ESD in terms of complete resection rate and control of recurrence rate.However,ESD treatment,fasting and hospitalization time is short,fewer complications,5-year survival rate is high;... |
PDF Full Text Request