Efficacy of beta-adrenergic blocker plus 5-isosorbide mononitrate and endoscopic band ligation for prophylaxis of esophageal variceal rebleeding: a meta-analysis.
World J Gastroenterol
; 15(17): 2151-5, 2009 May 07.
Article
en En
| MEDLINE
| ID: mdl-19418589
ABSTRACT
AIM:
To systematically assess the efficacy and safety of beta-adrenergic blocker plus 5-isosorbide mononitrate (BB + ISMN) and endoscopic band ligation (EBL) on prophylaxis of esophageal variceal rebleeding.METHODS:
Randomized controlled trials (RCTs) comparing the efficacy and safety of BB + ISMN and EBL on prophylaxis of esophageal variceal rebleeding were gathered from Medline, Embase, Cochrane Controlled Trial Registry and China Biological Medicine database between January 1980 and August 2007. Data from five trials were extracted and pooled. The analyses of the available data using the Revman 4.2 software were based on the intention-to-treat principle.RESULTS:
Four RCTs met the inclusion criteria. In comparison with BB + ISMN with EBL in prophylaxis of esophageal variceal rebleeding, there was no significant difference in the rate of rebleeding [relative risk (RR), 0.79; 95% CI 0.62-1.00; P = 0.05], bleeding-related mortality (RR, 0.76; 95% CI 0.31-1.42; P = 0.40), overall mortality (RR, 0.81; 95% CI 0.61-1.08; P = 0.15) and complications (RR, 1.26; 95% CI 0.93-1.70; P = 0.13).CONCLUSION:
In the prevention of esophageal variceal rebleeding, BB + ISMN are as effective as EBL. There are few complications with the two treatment modalities. Both BB + ISMN and EBL would be considered as the first-line therapy in the prevention of esophageal variceal rebleeding.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Contexto en salud:
6_ODS3_enfermedades_notrasmisibles
Problema de salud:
6_cirrhosis
/
6_digestive_diseases
Asunto principal:
Vasodilatadores
/
Várices Esofágicas y Gástricas
/
Antagonistas Adrenérgicos beta
/
Endoscopía
/
Dinitrato de Isosorbide
/
Ligadura
Tipo de estudio:
Clinical_trials
/
Etiology_studies
/
Systematic_reviews
Límite:
Humans
Idioma:
En
Revista:
World J Gastroenterol
Asunto de la revista:
GASTROENTEROLOGIA
Año:
2009
Tipo del documento:
Article
País de afiliación:
China