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Perioperative inter...
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Halle-Smith, James M.New Queen Elizabeth Hospital
(författare)
Perioperative interventions to reduce pancreatic fistula following pancreatoduodenectomy : meta-analysis
- Artikel/kapitelEngelska2022
Förlag, utgivningsår, omfång ...
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2022-06-21
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Oxford University Press (OUP),2022
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10 s.
Nummerbeteckningar
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LIBRIS-ID:oai:lup.lub.lu.se:feead520-ff47-4881-8da6-3c46326b23de
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https://lup.lub.lu.se/record/feead520-ff47-4881-8da6-3c46326b23deURI
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https://doi.org/10.1093/bjs/znac074DOI
Kompletterande språkuppgifter
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Språk:engelska
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Sammanfattning på:engelska
Ingår i deldatabas
Klassifikation
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Ämneskategori:art swepub-publicationtype
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Ämneskategori:ref swepub-contenttype
Anmärkningar
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BACKGROUND: Data on interventions to reduce postoperative pancreatic fistula (POPF) following pancreatoduodenectomy (PD) are conflicting. The aim of this study was to assimilate data from RCTs. METHODS: MEDLINE and Embase databases were searched systematically for RCTs evaluating interventions to reduce all grades of POPF or clinically relevant (CR) POPF after PD. Meta-analysis was undertaken for interventions investigated in multiple studies. A post hoc analysis of negative RCTs assessed whether these had appropriate statistical power. RESULTS: Among 22 interventions (7512 patients, 55 studies), 12 were assessed by multiple studies, and subjected to meta-analysis. Of these, external pancreatic duct drainage was the only intervention associated with reduced rates of both CR-POPF (odds ratio (OR) 0.40, 95 per cent c.i. 0.20 to 0.80) and all-POPF (OR 0.42, 0.25 to 0.70). Ulinastatin was associated with reduced rates of CR-POPF (OR 0.24, 0.06 to 0.93). Invagination (versus duct-to-mucosa) pancreatojejunostomy was associated with reduced rates of all-POPF (OR 0.60, 0.40 to 0.90). Most negative RCTs were found to be underpowered, with post hoc power calculations indicating that interventions would need to reduce the POPF rate to 1 per cent or less in order to achieve 80 per cent power in 16 of 34 (all-POPF) and 19 of 25 (CR-POPF) studies respectively. CONCLUSION: This meta-analysis supports a role for several interventions to reduce POPF after PD. RCTs in this field were often relatively small and underpowered, especially those evaluating CR-POPF.
Ämnesord och genrebeteckningar
Biuppslag (personer, institutioner, konferenser, titlar ...)
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Pande, RupalyNew Queen Elizabeth Hospital
(författare)
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Hall, LewisNew Queen Elizabeth Hospital
(författare)
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Hodson, JamesNew Queen Elizabeth Hospital
(författare)
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Roberts, Keith J.University of Birmingham,New Queen Elizabeth Hospital
(författare)
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Arshad, AliUniversity Hospital Southampton
(författare)
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Connor, SaxonChristchurch Hospital New Zealand
(författare)
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Conlon, Kevin C.P.Trinity College Dublin
(författare)
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Dickson, Euan J.Glasgow Royal Infirmary
(författare)
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Giovinazzo, FrancescoPoliclinico Universitario Agostino Gemelli
(författare)
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Harrison, EwenUniversity of Edinburgh
(författare)
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de Liguori Carino, NicolaManchester University NHS Foundation Trust
(författare)
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Hore, ToddChristchurch Hospital New Zealand
(författare)
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Knight, Stephen R.University of Edinburgh
(författare)
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Loveday, BenjaminRoyal Melbourne Hospital
(författare)
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Magill, LauraUniversity of Birmingham
(författare)
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Mirza, DariusNew Queen Elizabeth Hospital
(författare)
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Mitta, AnubhavRoyal North Shore Hospital
(författare)
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Pandanaboyana, SanjayFreeman Hospital
(författare)
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Perry, Rita J.University of Birmingham
(författare)
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Pinkney, ThomasUniversity of Birmingham
(författare)
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Samra, JasRoyal North Shore Hospital
(författare)
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Siriwardena, Ajith K.Manchester University NHS Foundation Trust
(författare)
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Satoi, SoheiKansai Medical University,University of Colorado
(författare)
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Skipworth, JamesUniversity Hospitals Bristol NHS Foundation Trust
(författare)
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Stättner, Stefan
(författare)
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Sutcliffe, Robert P.New Queen Elizabeth Hospital
(författare)
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Tingstedt, BobbyLund University,Lunds universitet,Lever-, pankreas- och gallvägskirurgi,Forskargrupper vid Lunds universitet,Hepato-Pancreato-Biliary Surgery,Lund University Research Groups(Swepub:lu)kir-bti
(författare)
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New Queen Elizabeth HospitalUniversity of Birmingham
(creator_code:org_t)
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PARANOIA Study Group
Sammanhörande titlar
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Ingår i:The British journal of surgery: Oxford University Press (OUP)109:9, s. 812-8211365-21680007-1323
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Halle-Smith, Jam ...
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Pande, Rupaly
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Hall, Lewis
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Hodson, James
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Roberts, Keith J ...
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Arshad, Ali
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visa fler...
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Connor, Saxon
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Conlon, Kevin C. ...
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Dickson, Euan J.
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Giovinazzo, Fran ...
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Harrison, Ewen
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de Liguori Carin ...
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Hore, Todd
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Knight, Stephen ...
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Loveday, Benjami ...
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Magill, Laura
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Mirza, Darius
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Mitta, Anubhav
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Pandanaboyana, S ...
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Perry, Rita J.
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Pinkney, Thomas
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Samra, Jas
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Siriwardena, Aji ...
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Satoi, Sohei
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Skipworth, James
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Stättner, Stefan
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Sutcliffe, Rober ...
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Tingstedt, Bobby
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visa färre...
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