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Is endoscopic retrograde appendicitis therapy a better modality for acute uncomplicated appendicitis? A systematic review and metaanalysis

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World Journal of Clinical Cases 2021年第33期9卷 10208-10221页

作者： Ying Wang Chen-Yu Sun Jie Liu Yue Chen Chandur Bhan john pocholo whitaker tuason Sudha Misra Yu-Ting Huang Shao-Di Ma Xing-Yu Cheng Qin Zhou Wen-Chao Gu Dan-Dan Wu Xia Chen Department of Endoscopy Center The First Affiliated Hospital of USTCDivision of Life Sciences and MedicineUniversity of Science and Technology of ChinaHefei 230001Anhui ProvinceChina Internal Medicine AMITA Health Saint Joseph Hospital ChicagoChicagoIL 60657United States Department of Gastroenterology The First Affiliated Hospital of USTCDivision of Life Sciences and MedicineUniversity of Science and Technology of ChinaHefei 230001Anhui ProvinceChina Department of Clinical Medicine School of the First Clinical MedicineAnhui Medical UniversityHefei 230032Anhui ProvinceChina University of Maryland Medical Center Midtown Campus BaltimoreMD 21201United States Department of Epidemiology and Health Statistics School of Public Health Anhui Medical UniversityHefei 230032Anhui ProvinceChina Department of Radiation Oncology Mayo ClinicRochesterMN 55905United States Department of Diagnostic Radiology and Nuclear Medicine Gunma University Graduate School of MedicineMaebashi 371-8511Japan Department of Nursing The First Affiliated Hospital of USTCDivision of Life Sciences and MedicineUniversity of Science and Technology of ChinaHefei 230001Anhui ProvinceChina

BACKGROUND Previous studies had shown endoscopic retrograde appendicitis therapy(ERAT)is an effective treatment for acute ***,different studies reported conflicting outcomes regarding the effectiveness of ERAT in comparison with laparoscopic appendectomy(LA).AIM To compare the effectiveness of ERAT with *** Randomized controlled trials(RCTs)and retrospective studies of ERAT for acute uncomplicated appendicitis were searched in PubMed,Cochrane Library,Web of Science,Embase database,China National Knowledge Infrastructure(CNKI),the WanFang Database,and Chinese Scientific Journals Database(VIP)from the establishment date to March *** was assessed using the Isquared *** odds ratios(OR),weighted mean difference(WMD),and standard mean difference(SMD),with 95%confidence intervals(CI)were calculated through either fixed-effects or random-effects *** analysis was also *** bias was tested by Egger's test,and Begg’s *** quality of included RCT were evaluated by the Jadad scale,while Newcastle-Ottawa scale is adopted for assessing the methodological quality of case-control *** statistical analysis was performed using Stata 15.1 statistical *** statistical analysis was performed using Stata 15.1 statistical *** study is registered with PROSPERO,*** After screening,10 RCTs and 2 case-control studies were included in the current systematic ***,the length of hospitalizations[WMD=-1.15,95%CI:-1.99,-0.31;P=0.007]was shorter than LA ***,the level of postoperative CRP[WMD=-10.06,95%CI:(-17.39,-2.73);P=0.007],TNF-α[WMD=-7.70,95%CI:(-8.47,-6.93);P<0.001],and IL-6 Levels[WMD=-9.78,95%CI:(-10.69,-8.88);P<0.001;P<0.001]in ERAT group was significantly lower than LA ***,ERAT group had a lower incidence of intestinal obstruction than LA group.[OR=0.19,95%CI:(0.05,0.79);P=0.020].Moreover,the quality of 10 RCTs were low with 0-3 J

关键词： Endoscopic retrograde appendicitis therapy Acute appendicitis Meta analysis Laparoscopic appendectomy Randomized controlled study

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