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A Meta-analysis on effectiveness of different surgical procedures in treating esophageal variceal bleeding in patients with portal hypertension / 中华肝胆外科杂志
Chinese Journal of Hepatobiliary Surgery ; (12): 230-234, 2017.
Artigo em Chinês | WPRIM | ID: wpr-608220
ABSTRACT
Objective To compare the effectiveness of surgical procedures (devascularization,shunt and combined shunt and devascularization) in treating recurrent variceal bleeding and other complications in patients with portal hypertension.Methods A systematic literature search was carried out on patients with portal hypertension,and a Meta-analysis was conducted using Revman 5.3 software to evaluate the effectiveness of different surgical procedures on recurrent esophageal variceal bleeding,hepatic encephalopathy,operative mortality and survival rates.Results A total of 24 trials were finally selected using predetermined inclusion criteria.Meta-analysis showed there was no significant difference among the three operations on operative mortality (P > 0.05).The rebleeding rate of the combined group was significantly lower than the devascularization group (P < 0.05).The encephalopathy rate of the combined group was significantly lower than the shunt group (P < 0.05),and the 1-year and 3-year survival rates of the combined group were better than the devascularization group (both P < 0.05),but there were no significant difference in the 5-year survival rates between these two groups (P > 0.18).The 1-year and 3-year survival rates were not significantly different between the combined and the shunt groups (both P > 0.05).Conclusions Combined shunt and devascularization had better therapeutic effectiveness than either devascularization alone or shunt alone in patients with portal hypertension with a high rebleeding risk.There were no significant difference among the three surgical procedures in operative mortality.The survival rates of combined surgery were significantly better than devascrlarization alone.

Texto completo: DisponíveL Índice: WPRIM (Pacífico Ocidental) Tipo de estudo: Revisões Sistemáticas Avaliadas Idioma: Chinês Revista: Chinese Journal of Hepatobiliary Surgery Ano de publicação: 2017 Tipo de documento: Artigo

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Texto completo: DisponíveL Índice: WPRIM (Pacífico Ocidental) Tipo de estudo: Revisões Sistemáticas Avaliadas Idioma: Chinês Revista: Chinese Journal of Hepatobiliary Surgery Ano de publicação: 2017 Tipo de documento: Artigo