RESUMO
Objective To study the safety and effectiveness of infra-hepatic inferior vena cava clamping combined with Pringle' s maneuver during hepatectomy. Methods The databases of PubMed, Cochrane Center, CNKI, VIP, Wan Fang were searched to extract the relevant data for the meta-analysis using the Revmanage 5. 3 software. Results A total of 14 studies with 1595 patients were included in this meta-analysis. The results showed that total bleeding during the combined clamping was significantly lower than that of the Pringle's maneuver alone (MD= -314. 59, 95％CI:-362. 37～ -266. 81, P<0. 05). Bleeding during hepatectomy was significantly lower ( MD= -217. 79, 95％ CI: -284. 57 ～ -151. 00, P<0. 05); so was the intraoperative blood transfusion rate ( OR = 0. 48, 95％ CI: 0. 36 ～ 0. 62, P<0. 05). The incidence of complications was significantly lower (OR =0. 74, 95％ CI: 0. 57 ～0. 95, P<0. 05). However, there were no significant differences in operation time, length of hospital stay, intrao-perative monitoring index and postoperative liver and kidney function recovery ( P >0. 05 ) . Conclusions Infra-hepatic inferior vena cava clamping combined with Pringle' s maneuver in hepatectomy was safe and reliable. Compared with the Pringle' s maneuver alone, the combined technique reduce bleeding and the incidence of complications. This technique is worth promoting in clinical practice.
RESUMO
Objective@#To study the safety and effectiveness of infra-hepatic inferior vena cava clamping combined with Pringle’s maneuver during hepatectomy.@*Methods@#The databases of PubMed, Cochrane Center, CNKI, VIP, Wan Fang were searched to extract the relevant data for the meta-analysis using the Revmanage 5.3 software.@*Results@#A total of 14 studies with 1595 patients were included in this meta-analysis. The results showed that total bleeding during the combined clamping was significantly lower than that of the Pringle’s maneuver alone (MD=-314.59, 95%CI: -362.37~-266.81, P<0.05). Bleeding during hepatectomy was significantly lower (MD=-217.79, 95% CI: -284.57~-151.00, P<0.05); so was the intraoperative blood transfusion rate (OR=0.48, 95% CI: 0.36~0.62, P<0.05). The incidence of complications was significantly lower (OR=0.74, 95% CI: 0.57~0.95, P<0.05). However, there were no significant differences in operation time, length of hospital stay, intraoperative monitoring index and postoperative liver and kidney function recovery (P>0.05).@*Conclusions@#Infra-hepatic inferior vena cava clamping combined with Pringle’s maneuver in hepatectomy was safe and reliable. Compared with the Pringle’s maneuver alone, the combined technique reduce bleeding and the incidence of complications. This technique is worth promoting in clinical practice.