Meta-analysis of repeated endoscopic sclerotherapy and ligation for prevention of esophageal variceal rehaemorrhagia in cirrhosis / 上海第二医科大学学报

ABSTRACT

Objective To evaluate the efficacy and safety of repeated endoscopic sclerotherapy injection(ESI) and endoscopic variceal ligation(EVL) in eradication of esophageal varices among patients who survive an episode of first variceal hemorrhage with a high risk of rehaemorrhagia and death. Methods The correlated literatures were identified from Medline,Embsae,the Library Cochrance,PubMed and CNKI.RevMan 4.2 Software provided by the Library Cochrance was used for data analysis. Results A total of 4 randomized controlled trials were included.It was demonstrated that there was no significant difference in the esophageal varices eradication rate between repeated ESI and EVL(OR=0.75,95%CI 0.48-1.15;P=0.19).However,the rehaemorrhagia rate of EVL after emergency hemostasis was significantly lower than that of ESI(OR=2.19,95%CI1.44-3.31;P=0.000 2).Meanwhile,there was no significant difference in mortality between ESI and EVL(OR=1.34,95%CI0.82-2.17;P=0.24).Little publication bias was found with funnel plot analysis. Conclusion EVL outperforms ESL in prevention of rehaemorrhagia in treatment of esophageal varices,while does no better than ESL in eradication of esophageal varices and mortality.