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Endoscopic Vacuum Therapy in Patients with Transmural Defects of the Upper Gastrointestinal Tract: A Systematic Review with Meta-Analysis

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dc.contributor.author윤해룡-
dc.contributor.author이세준-
dc.contributor.author정다현-
dc.contributor.author허철웅-
dc.date.accessioned2021-09-29T00:45:54Z-
dc.date.available2021-09-29T00:45:54Z-
dc.date.issued2021-05-
dc.identifier.urihttps://ir.ymlib.yonsei.ac.kr/handle/22282913/184025-
dc.description.abstractA transmural defect of the upper gastrointestinal (UGI) tract is a life-threatening condition associated with high morbidity and mortality. Recently, endoscopic vacuum therapy (EVT) was used for managing UGI defects and showed promising results. We conducted a systematic review and meta-analysis to synthesize evidence on the efficacy of EVT in patients with transmural defects of the UGI tract. We searched the PubMed, Cochrane Library, and Embase databases for publications on the effect of EVT on successful closure, mortality, complications, and post-EVT strictures. Methodological quality was assessed using the Newcastle-Ottawa quality assessment scale. This meta-analysis included 29 studies involving 498 participants. The pooled estimate rate of successful closure with EVT was 0.85 (95% confidence interval [CI]: 0.81-0.88). The pooled estimate rates for mortality, complications, and post-EVT strictures were 0.11, 0.10, and 0.14, respectively. According to the etiology of the transmural defect (perforation vs. leak and fistula), no significant difference was observed in successful closure (odds ratio [OR]: 1.45, 95% CI: 0.45-4.67, p = 0.53), mortality (OR: 0.77, 95% CI: 0.24-2.46, p = 0.66), complications (OR: 0.94, 95% CI: 0.17-5.15, p = 0.94), or post-EVT stricture rates (OR: 0.70, 95% CI: 0.12-4.24, p = 0.70). The successful closure rate was significantly higher with EVT than with self-expanding metal stent (SEMS) placement (OR: 3.14, 95% CI: 1.23-7.98, p = 0.02). EVT is an effective and safe treatment for leaks and fistulae, as well as for perforations in the UGI. Moreover, EVT seems to be a better treatment option than SEMS placement for UGI defects.-
dc.description.statementOfResponsibilityopen-
dc.languageEnglish-
dc.publisherMDPI AG-
dc.relation.isPartOfJOURNAL OF CLINICAL MEDICINE-
dc.rightsCC BY-NC-ND 2.0 KR-
dc.titleEndoscopic Vacuum Therapy in Patients with Transmural Defects of the Upper Gastrointestinal Tract: A Systematic Review with Meta-Analysis-
dc.typeArticle-
dc.contributor.collegeCollege of Medicine (의과대학)-
dc.contributor.departmentDept. of Internal Medicine (내과학교실)-
dc.contributor.googleauthorDa Hyun Jung-
dc.contributor.googleauthorHae-Ryong Yun-
dc.contributor.googleauthorSe Joon Lee-
dc.contributor.googleauthorNa Won Kim-
dc.contributor.googleauthorCheal Wung Huh-
dc.identifier.doi10.3390/jcm10112346-
dc.contributor.localIdA04617-
dc.contributor.localIdA02882-
dc.contributor.localIdA03591-
dc.contributor.localIdA05070-
dc.relation.journalcodeJ03556-
dc.identifier.eissn2077-0383-
dc.identifier.pmid34071877-
dc.subject.keywordendoscopic vacuum therapy-
dc.subject.keywordetiology-
dc.subject.keywordtransmural defect-
dc.subject.keywordupper gastrointestinal tract-
dc.contributor.alternativeNameYun, Hae Ryong-
dc.contributor.affiliatedAuthor윤해룡-
dc.contributor.affiliatedAuthor이세준-
dc.contributor.affiliatedAuthor정다현-
dc.contributor.affiliatedAuthor허철웅-
dc.citation.volume10-
dc.citation.number11-
dc.citation.startPage2346-
dc.identifier.bibliographicCitationJOURNAL OF CLINICAL MEDICINE, Vol.10(11) : 2346, 2021-05-
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers

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