Comparison between Endoscopic Submucosal Dissection and Transanal Endoscopic Microsurgery in Early Rectal Neuroendocrine Tumor Patients: A Meta-Analysis
AbstractPurpose To compare the effectiveness, safety and cost-effectiveness of endoscopic submucosal dissection (ESD) with transanal endoscopic microsurgery (TEM) in early rectal neuroendocrine tumor (RNET) patients. This article will provide reliable evidence for surgeons in regards to clinical dec...
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2023-12-01
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| Series: | Journal of Investigative Surgery |
| Subjects: | |
| Online Access: | https://www.tandfonline.com/doi/10.1080/08941939.2023.2278191 |
| _version_ | 1797626729298132992 |
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| author | Fu-Gang Wang Ying Jiang Chao Liu Hong Qi |
| author_facet | Fu-Gang Wang Ying Jiang Chao Liu Hong Qi |
| author_sort | Fu-Gang Wang |
| collection | DOAJ |
| description | AbstractPurpose To compare the effectiveness, safety and cost-effectiveness of endoscopic submucosal dissection (ESD) with transanal endoscopic microsurgery (TEM) in early rectal neuroendocrine tumor (RNET) patients. This article will provide reliable evidence for surgeons in regards to clinical decision-making.Methods Systematic literature retrieval was performed in Pubmed, Embase and Cochrane database from 2013/4/30 to 2023/4/30. Methodology validation was performed by using the Newcastle–Ottawa Scale (NOS). Data-analysis was conducted by using the Review manager version 5.3 software.Results A total of three retrospective studies were included in our meta-analysis. All eligible studies were considered to be high quality. By comparing baseline characteristics between TEM and ESD, patients in the TEM group seemed to be characterized by a larger tumor size and lower tumor level, even though no statistical significance was found. Clear statistical significance favoring TEM was identified in terms of R0 resection rate, procedure time and hospital stay. No statistical significance was found in terms of recurrence rate, adverse events rate and additional treatment rate.Conclusions Compared with ESD, TEM was a more effective treatment modality for early RNET patients; it was associated with a relatively higher R0 resection rate and a similar degree of safety. However, the relatively higher cost and complicated manipulation restricted the promotion of TEM. Surgeons should opt for TEM as a primary treatment in patients with a larger tumor size and deeper degree of tumorous infiltration if the financial condition and hospital facility permit. |
| first_indexed | 2024-03-11T10:14:20Z |
| format | Article |
| id | doaj.art-f94508b94fb347768e778391d47232c8 |
| institution | Directory Open Access Journal |
| issn | 0894-1939 1521-0553 |
| language | English |
| last_indexed | 2024-03-11T10:14:20Z |
| publishDate | 2023-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Journal of Investigative Surgery |
| spelling | doaj.art-f94508b94fb347768e778391d47232c82023-11-16T11:00:33ZengTaylor & Francis GroupJournal of Investigative Surgery0894-19391521-05532023-12-0136110.1080/08941939.2023.2278191Comparison between Endoscopic Submucosal Dissection and Transanal Endoscopic Microsurgery in Early Rectal Neuroendocrine Tumor Patients: A Meta-AnalysisFu-Gang Wang0Ying Jiang1Chao Liu2Hong Qi3Department of General Surgery, Qingdao Hospital, University of Health and Rehabilitation Sciences (Qingdao Municipal Hospital), Qingdao, Shandong, PR ChinaDepartment of Burn and Plastic Surgery, Qingdao Hospital, University of Health and Rehabilitation Sciences (Qingdao Municipal Hospital), Qingdao, Shandong, PR ChinaDepartment of General Surgery, Qingdao Hospital, University of Health and Rehabilitation Sciences (Qingdao Municipal Hospital), Qingdao, Shandong, PR ChinaDepartment of General Surgery, Qingdao Hospital, University of Health and Rehabilitation Sciences (Qingdao Municipal Hospital), Qingdao, Shandong, PR ChinaAbstractPurpose To compare the effectiveness, safety and cost-effectiveness of endoscopic submucosal dissection (ESD) with transanal endoscopic microsurgery (TEM) in early rectal neuroendocrine tumor (RNET) patients. This article will provide reliable evidence for surgeons in regards to clinical decision-making.Methods Systematic literature retrieval was performed in Pubmed, Embase and Cochrane database from 2013/4/30 to 2023/4/30. Methodology validation was performed by using the Newcastle–Ottawa Scale (NOS). Data-analysis was conducted by using the Review manager version 5.3 software.Results A total of three retrospective studies were included in our meta-analysis. All eligible studies were considered to be high quality. By comparing baseline characteristics between TEM and ESD, patients in the TEM group seemed to be characterized by a larger tumor size and lower tumor level, even though no statistical significance was found. Clear statistical significance favoring TEM was identified in terms of R0 resection rate, procedure time and hospital stay. No statistical significance was found in terms of recurrence rate, adverse events rate and additional treatment rate.Conclusions Compared with ESD, TEM was a more effective treatment modality for early RNET patients; it was associated with a relatively higher R0 resection rate and a similar degree of safety. However, the relatively higher cost and complicated manipulation restricted the promotion of TEM. Surgeons should opt for TEM as a primary treatment in patients with a larger tumor size and deeper degree of tumorous infiltration if the financial condition and hospital facility permit.https://www.tandfonline.com/doi/10.1080/08941939.2023.2278191Endoscopic submucosal dissectiontransanal endoscopic microsurgeryrectal neuroendocrine tumorlocal excision |
| spellingShingle | Fu-Gang Wang Ying Jiang Chao Liu Hong Qi Comparison between Endoscopic Submucosal Dissection and Transanal Endoscopic Microsurgery in Early Rectal Neuroendocrine Tumor Patients: A Meta-Analysis Journal of Investigative Surgery Endoscopic submucosal dissection transanal endoscopic microsurgery rectal neuroendocrine tumor local excision |
| title | Comparison between Endoscopic Submucosal Dissection and Transanal Endoscopic Microsurgery in Early Rectal Neuroendocrine Tumor Patients: A Meta-Analysis |
| title_full | Comparison between Endoscopic Submucosal Dissection and Transanal Endoscopic Microsurgery in Early Rectal Neuroendocrine Tumor Patients: A Meta-Analysis |
| title_fullStr | Comparison between Endoscopic Submucosal Dissection and Transanal Endoscopic Microsurgery in Early Rectal Neuroendocrine Tumor Patients: A Meta-Analysis |
| title_full_unstemmed | Comparison between Endoscopic Submucosal Dissection and Transanal Endoscopic Microsurgery in Early Rectal Neuroendocrine Tumor Patients: A Meta-Analysis |
| title_short | Comparison between Endoscopic Submucosal Dissection and Transanal Endoscopic Microsurgery in Early Rectal Neuroendocrine Tumor Patients: A Meta-Analysis |
| title_sort | comparison between endoscopic submucosal dissection and transanal endoscopic microsurgery in early rectal neuroendocrine tumor patients a meta analysis |
| topic | Endoscopic submucosal dissection transanal endoscopic microsurgery rectal neuroendocrine tumor local excision |
| url | https://www.tandfonline.com/doi/10.1080/08941939.2023.2278191 |
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