Introduction: Several endoscopic methods can be employed to manage post-bariatric leaks. However, endoluminal vacuum therapy (EVT) and endoscopic internal drainage (EID) are relatively new methods, and studies regarding these methods are scarce. We performed a systematic review of the literature and a meta-analysis to evaluate the efficacy of EVT and EID. Methods: Databases were searched for eligible studies. The clinical success of leak closure was the primary outcome of interest. A proportional meta-analysis was performed for pooling the primary outcome using a fixed-effects model. A meta-analysis or descriptive analysis of other outcomes was performed based on the data availability. Results: Data from 3 EVT and 10 EID studies (n = 279) were used for evidence synthesis. The leak closure rates (95% confidence interval [CI]) of EVT and EID were 85.2% (75.1%–95.4%) and 91.6% (88.1%–95.2%), respectively. The corresponding mean treatment durations (95% CI) were 28 (2.4–53.6) and 78.4 (50.1–106.7) days, respectively. However, data about other outcomes were extremely limited; thus, a pooled analysis could not be performed. Conclusions: Both EVT and EID were effective when used as the first-line treatment for post-bariatric leaks. However, larger studies must be conducted to compare the efficacy of the 2 interventions.
Visc Med

中文翻译：

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负压疗法和内部引流作为减肥后渗漏的一线内镜治疗：系统评价和荟萃分析

简介：可以采用几种内窥镜方法来管理减肥后的渗漏。然而，腔内负压治疗（EVT）和内窥镜内引流（EID）是相对较新的方法，关于这些方法的研究很少。我们对文献进行了系统回顾和荟萃分析，以评估 EVT 和 EID 的疗效。方法：在数据库中搜索符合条件的研究。泄漏闭合的临床成功是感兴趣的主要结果。使用固定效应模型对主要结果进行了比例荟萃分析。根据数据可用性对其他结果进行荟萃分析或描述性分析。结果：来自 3 项 EVT 和 10 项 EID 研究的数据（ n= 279) 用于证据合成。EVT 和 EID 的泄漏闭合率（95% 置信区间 [CI]）分别为 85.2%（75.1%–95.4%）和 91.6%（88.1%–95.2%）。相应的平均治疗时间 (95% CI) 分别为 28 (2.4-53.6) 和 78.4 (50.1-106.7) 天。然而，关于其他结果的数据极其有限；因此，无法进行汇总分析。结论： EVT 和 EID 在用作减肥后漏的一线治疗时都是有效的。然而，必须进行更大规模的研究来比较两种干预措施的功效。
粘性医学