Author/Authors :
Wen, Zi Radiology Intervention Department - Puyang Oilfield General Hospital, Puyang, China , Chao Liu, Jin Radiology Intervention Department - Puyang Oilfield General Hospital, Puyang, China , Zhao, Fang Radiology Intervention Department - Puyang Oilfield General Hospital, Puyang, China , Guang Zhang, Wen Radiology Intervention Department - First Affiliated Hospital of Zhengzhou University, Zhengzhou, China , Duan, Xu Hua Radiology Intervention Department - First Affiliated Hospital of Zhengzhou University, Zhengzhou, China , Fei Chen, Peng Radiology Intervention Department - First Affiliated Hospital of Zhengzhou University, Zhengzhou, China , Yang, Si Fu Radiology Intervention Department - Puyang Oilfield General Hospital, Puyang, China , Wei Li, Hong Radiology Intervention Department - Puyang Oilfield General Hospital, Puyang, China , Wen Chen, Fu Radiology Intervention Department - Puyang Oilfield General Hospital, Puyang, China , Sheng Shi, Hong Radiology Intervention Department - Puyang Oilfield General Hospital, Puyang, China , Zhuang Ren, Jian Radiology Intervention Department - First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
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.
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.
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);
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
