Li Hou1,2, Tiehao Wang2, Jiarong Wang2, Jichun Zhao2, Ding Yuan2. 1. West China School of Medicine, West China Hospital, 34753Sichuan University, Chengdu, China. 2. Department of Vascular Surgery, West China Hospital, 34753Sichuan University, Chengdu, China.
Abstract
OBJECTIVE: Acute mesenteric ischemia is a disease with high morbidity and mortality, and it is traditionally treated with open surgery. Endovascular therapy and hybrid techniques are alternative treatments that are also currently available. We performed a meta-analysis to evaluate the outcomes of the different treatment approaches in the last 20 years. METHODS: Studies on acute mesenteric ischemia that were indexed in PubMed, Embase, and MEDLINE databases (from January 1, 2000, to April 1, 2021) were reviewed. All related retrospective observational studies and case series were included. A random-effects model was used to calculate pooled estimates, and the results were reported as proportions and 95% confidence intervals (CIs). RESULTS: In our study, a total of 2369 patients (in 39 studies) underwent endovascular, open surgery, or retrograde open mesenteric stenting. The pooled mortality estimates for open surgery, endovascular therapy, and retrograde open mesenteric stenting were 40% (95% CI, 0.33-0.47; I2 = 84%), 26% (95% CI, 0.19-0.33; I2 = 33%), and 32% (95% CI, 0.21-0.44; I2 = 26%), respectively. CONCLUSIONS: The mortality associated with open surgical treatment, endovascular therapy, and retrograde open mesenteric stenting tend to be similar in the last 20 years.
OBJECTIVE: Acute mesenteric ischemia is a disease with high morbidity and mortality, and it is traditionally treated with open surgery. Endovascular therapy and hybrid techniques are alternative treatments that are also currently available. We performed a meta-analysis to evaluate the outcomes of the different treatment approaches in the last 20 years. METHODS: Studies on acute mesenteric ischemia that were indexed in PubMed, Embase, and MEDLINE databases (from January 1, 2000, to April 1, 2021) were reviewed. All related retrospective observational studies and case series were included. A random-effects model was used to calculate pooled estimates, and the results were reported as proportions and 95% confidence intervals (CIs). RESULTS: In our study, a total of 2369 patients (in 39 studies) underwent endovascular, open surgery, or retrograde open mesenteric stenting. The pooled mortality estimates for open surgery, endovascular therapy, and retrograde open mesenteric stenting were 40% (95% CI, 0.33-0.47; I2 = 84%), 26% (95% CI, 0.19-0.33; I2 = 33%), and 32% (95% CI, 0.21-0.44; I2 = 26%), respectively. CONCLUSIONS: The mortality associated with open surgical treatment, endovascular therapy, and retrograde open mesenteric stenting tend to be similar in the last 20 years.
Entities:
Keywords:
Acute mesenteric ischemia; endovascular therapy; stent; vascular surgery
Authors: Miklosh Bala; Fausto Catena; Jeffry Kashuk; Belinda De Simone; Carlos Augusto Gomes; Dieter Weber; Massimo Sartelli; Federico Coccolini; Yoram Kluger; Fikri M Abu-Zidan; Edoardo Picetti; Luca Ansaloni; Goran Augustin; Walter L Biffl; Marco Ceresoli; Osvaldo Chiara; Massimo Chiarugi; Raul Coimbra; Yunfeng Cui; Dimitris Damaskos; Salomone Di Saverio; Joseph M Galante; Vladimir Khokha; Andrew W Kirkpatrick; Kenji Inaba; Ari Leppäniemi; Andrey Litvin; Andrew B Peitzman; Vishal G Shelat; Michael Sugrue; Matti Tolonen; Sandro Rizoli; Ibrahima Sall; Solomon G Beka; Isidoro Di Carlo; Richard Ten Broek; Chirika Mircea; Giovanni Tebala; Michele Pisano; Harry van Goor; Ronald V Maier; Hans Jeekel; Ian Civil; Andreas Hecker; Edward Tan; Kjetil Soreide; Matthew J Lee; Imtiaz Wani; Luigi Bonavina; Mark A Malangoni; Kaoru Koike; George C Velmahos; Gustavo P Fraga; Andreas Fette; Nicola de'Angelis; Zsolt J Balogh; Thomas M Scalea; Gabriele Sganga; Michael D Kelly; Jim Khan; Philip F Stahel; Ernest E Moore Journal: World J Emerg Surg Date: 2022-10-19 Impact factor: 8.165