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find Author "WANG Genwang" 1 results
  • Endoscopic pneumatic dilationversus endoscopic stent placement in treatment of achalasia: a meta-analysis

    Objective To systematically evaluate efficacy and safety of endoscopic pneumatic dilation and endoscopic stent placement in treatment of achalasia. Methods Eligible studies comparing the pneumatic dilation and the stent placement in treatment of achalasia were identified by an electronic search of MedLine, Embase, ISI Web of Science, the Cochrane Database, China Biology Medicine and Wanfang databases from inception to December 2015. Two reviewers independently screened the literatures, extracted data, and assessed the risk of bias of included studies. Then, RevMan 5.3 software was used for meta-analysis. Results A total of 4 randomized controlled trials including 343 patients with achalasia (176 cases in the pneumatic dilation group, 167 cases in the stent placement group) were subjected to the final analysis. The results of meta-analysis showed that the postoperative short term symptom relief rate had no significant difference between the pneumatic dilation group and the stent placement group 〔RR=1.03, 95%CI (0.95, 1.12),P=0.53〕, the postoperative 2-year symptom relief rate of the stent placement group was significantly higher than that of the pneumatic dilation group 〔RR=0.77, 95%CI (0.64, 0.92),P=0.005〕, but the complications rate of the stent placement group was significantly higher as compared with the pneumatic dilation group 〔RR=0.52, 95%CI (0.40, 0.69),P<0.000 01〕 too. Conclusions Although this meta-analysis has some shortcomings, preliminary results show that short term effects of pneumatic dilation and stent placement in treatment of achalasia are effective, long term effect of stent placement in treatment of achalasia is better as compared with pneumatic dilation, but it’s complications rate is higher. So in clinical diagnosis and treatment, effect, risk, patient’s physical condition, and demand should be considered together; during treatment, we should pay attention to adverse reactions and prepare adequately in order to reducing complications. When complications occur, we should take timely symptomatic treatment.

    Release date:2017-04-18 03:08 Export PDF Favorites Scan
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