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Comparison of the Effects of TIPS versus BRTO on Bleeding Gastric Varices: A Meta-Analysis.
- Source :
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Canadian journal of gastroenterology & hepatology [Can J Gastroenterol Hepatol] 2020 Feb 11; Vol. 2020, pp. 5143013. Date of Electronic Publication: 2020 Feb 11 (Print Publication: 2020). - Publication Year :
- 2020
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Abstract
- Background and Aim . Upper gastrointestinal bleeding is a threat to patients with gastric varices (GVs). Previous studies have concluded that both transjugular intrahepatic portosystemic shunt (TIPS) and balloon-occluded retrograde transvenous obliteration (BRTO) are effective treatments for patients with GV. We aimed to compare the efficiency and outcomes of these two procedures in GV patients through meta-analysis.<br />Methods: The PubMed, Cochrane Library, EMBASE, and Web of Science databases were searched using the keywords: GV, bleeding, TIPS, and BRTO to identify relevant randomized controlled trials and cohort studies. The overall survival (OS) rate, imminent haemostasis rate, rebleeding rate, technical success rate, procedure complication rate (hepatic encephalopathy and aggravated ascites), and Child-Pugh score were evaluated. Randomized clinical trials and cohort studies comparing TIPS and BRTO for GV due to portal hypertension were included in our meta-analysis. Two independent reviewers performed data extraction and assessed the study quality. A meta-analysis was performed to calculate risk ratios (RRs), mean differences (MDs), and 95% CIs using random effects models.<br />Results: A total of nine studies fulfilled the inclusion criteria. There was a significant difference between TIPS and BRTO in the OS rate (RR, 0.81 (95% CI, 0.66 to 0.98); P =0.03) and rebleeding rate (RR, 2.61 (95% CI, 1.75 to 3.90); P =0.03) and rebleeding rate (RR, 2.61 (95% CI, 1.75 to 3.90); P =0.03) and rebleeding rate (RR, 2.61 (95% CI, 1.75 to 3.90); P =0.03) and rebleeding rate (RR, 2.61 (95% CI, 1.75 to 3.90); P =0.03) and rebleeding rate (RR, 2.61 (95% CI, 1.75 to 3.90); P =0.03) and rebleeding rate (RR, 2.61 (95% CI, 1.75 to 3.90); P =0.03) and rebleeding rate (RR, 2.61 (95% CI, 1.75 to 3.90).<br />Conclusions: In this meta-analysis, BRTO brought more benefits to patients, with a higher OS rate and lower rebleeding rate. BRTO is a feasible method for GVB.<br />Competing Interests: The authors declare that they have no conflicts of interest.<br /> (Copyright © 2020 Zi Wen Wang et al.)
- Subjects :
- Cohort Studies
Esophageal and Gastric Varices etiology
Feasibility Studies
Female
Gastrointestinal Hemorrhage etiology
Humans
Male
Middle Aged
Randomized Controlled Trials as Topic
Treatment Outcome
Balloon Occlusion methods
Esophageal and Gastric Varices therapy
Gastrointestinal Hemorrhage therapy
Hypertension, Portal complications
Portasystemic Shunt, Transjugular Intrahepatic methods
Subjects
Details
- Language :
- English
- ISSN :
- 2291-2797
- Volume :
- 2020
- Database :
- MEDLINE
- Journal :
- Canadian journal of gastroenterology & hepatology
- Publication Type :
- Academic Journal
- Accession number :
- 32104670
- Full Text :
- https://doi.org/10.1155/2020/5143013