Prophylactic transcatheter arterial embolization reduces rebleeding in non-variceal upper gastrointestinal bleeding: A meta-analysis  

作　　者：Eszter Boros Zoltán Sipos Péter Hegyi Brigitta Teutsch Levente Frim Szilárd Váncsa Szabolcs Kiss FanniDembrovszky Eduard Oštarijaš Andrew Shawyer Bálint Erőss 

机构地区：[1]Institute for Translational Medicine,University of Pecs,Medical School,Pécs 7624,Hungary [2]First Department of Internal Medicine,St.George University Teaching Hospital of County Fejér,Székesfehérvár 8000,Hungary [3]Szentágothai Research Center,University of Pecs,Pécs 7624,Hungary [4]Doctoral School of Clinical Medicine,University of Szeged,Szeged 6720,Hungary [5]Department of Interventional Radiology,University Hospitals Dorset NHS Foundation Trust,Bournemouth BH77DW,United Kingdom

出　　处：《World Journal of Gastroenterology》2021年第40期6985-6999,共15页世界胃肠病学杂志（英文版）

基　　金：by Economic Development and Innovation Operative Programme Grant,No.GINOP 2.3.2-15-2016-00048 and No.GINOP-2.3.4-15-2020-00010;Human Resources Development Operational Programme Grant,No.EFOP-3.6.2-16-2017-00006 and No.EFOP-3.6.1.-16-2016-00004.

摘　　要：BACKGROUND Despite the improvement in the endoscopic hemostasis of non-variceal upper gastrointestinal bleeding(NVUGIB),rebleeding remains a major concern.AIM To assess the role of prophylactic transcatheter arterial embolization(PTAE)added to successful hemostatic treatment among NVUGIB patients.METHODS We searched three databases from inception through October 19th,2020.Randomized controlled trials(RCTs)and observational cohort studies were eligible.Studies compared patients with NVUGIB receiving PTAE to those who did not get PTAE.Investigated outcomes were rebleeding,mortality,reintervention,need for surgery and transfusion,length of hospital(LOH),and intensive care unit(ICU)stay.In the quantitative synthesis,odds ratios(ORs)and weighted mean differences(WMDs)were calculated with the random-effects model and interpreted with 95%confidence intervals(CIs).RESULTS We included a total of 3 RCTs and 9 observational studies with a total of 1329 patients,with 486 in the intervention group.PTAE was associated with lower odds of rebleeding(OR=0.48,95%CI:0.29–0.78).There was no difference in the 30-d mortality rates(OR=0.82,95%CI:0.39–1.72)between the PTAE and control groups.Patients who underwent PTAE treatment had a lower chance for reintervention(OR=0.48,95%CI:0.31–0.76)or rescue surgery(OR=0.35,95%CI:0.14–0.92).The LOH and ICU stay was shorter in the PTAE group,but the difference was non-significant[WMD=-3.77,95%CI:(-8.00)–0.45;WMD=-1.33,95%CI:(-2.84)–0.18,respectively].CONCLUSION PTAE is associated with lower odds of rebleeding and any reintervention in NVUGIB.However,further RCTs are needed to have a higher level of evidence.

关 键 词：Prophylactic transcatheter arterial embolization Non-variceal upper gastrointestinal bleeding REBLEEDING REINTERVENTION META-ANALYSIS REVIEW 

分 类 号：R573.2[医药卫生—消化系统]