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Efficacy of routine second-look endoscopy after endoscopic hemostasis in patients with acute peptic ulcer bleeding: systematic review and meta-analysis.
Benites-Goñi, Harold; Alférez-Andía, Jessica; Piscoya, Alejandro; Diaz-Arocutipa, Carlos; Hernandez, Adrian V.
Afiliación
  • Benites-Goñi H; Unidad de Revisiones Sistemáticas y Meta-análisis (URSIGET), Vicerrectorado de Investigación, Universidad San Ignacio de Loyola. Lima, Peru; Hospital Nacional Edgardo Rebagliati Martins. Lima, Peru.
  • Alférez-Andía J; Instituto Nacional de Enfermedades Neoplásicas. Lima, Peru.
  • Piscoya A; Hospital Guillermo Kaelin de la Fuente. Lima, Peru.
  • Diaz-Arocutipa C; Unidad de Revisiones Sistemáticas y Meta-análisis (URSIGET), Vicerrectorado de Investigación, Universidad San Ignacio de Loyola. Lima, Peru.
  • Hernandez AV; Unidad de Revisiones Sistemáticas y Meta-análisis (URSIGET), Vicerrectorado de Investigación, Universidad San Ignacio de Loyola. Lima, Peru; Health Outcomes, Policy and Evidence synthesis (HOPES) Group, University of Connecticut School of Pharmacy. Storrs, CT, USA.
Rev Gastroenterol Peru ; 44(2): 117-124, 2024.
Article en En | MEDLINE | ID: mdl-39019804
ABSTRACT

OBJECTIVE:

To evaluate the efficacy of scheduled second-look endoscopy in patients with acute peptic ulcer bleeding (PUB). MATERIALS AND

METHODS:

We systematically search in four databases for randomized controlled trials (RCTs) that evaluated the usefulness of scheduled second-look endoscopy vs. single endoscopy in patients with PUB. Our primary outcome was rebleeding. Secondary outcomes were surgery, mortality, and the number of units of blood transfused (NUBT). All meta-analyses were performed using a random-effects model. Pooled risk ratio (RR) and mean difference (MD), with their 95% confidence intervals (CIs) were calculated for categorical and continuous outcomes, respectively. The risk of bias was assessed using the Cochrane RoB 2.0 tool, and the quality of evidence (QoE) was rated with the GRADE approach.

RESULTS:

Eight full-text RCTs and two RCT abstracts were included (n=1513). We did not find differences in rebleeding (RR, 0.78; 95% CI, 0.53-1.14, moderate QoE), surgery (RR, 0.58; 95% CI, 0.29-1.15, moderate QoE), mortality (RR, 0.89; 95% CI, 0.46-1.71, moderate QoE) or NUBT (MD, -0.01 units; 95% CI, -0.3 to 0.28, low QoE) between second-look and single endoscopy. Sensitivity analyses had similar results to the main analyses.

CONCLUSIONS:

Routine second-look endoscopy was not more efficacious than single endoscopy in patients with PUB.
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Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Úlcera Péptica Hemorrágica / Hemostasis Endoscópica / Segunda Cirugía Límite: Humans Idioma: En Revista: Rev Gastroenterol Peru Asunto de la revista: GASTROENTEROLOGIA Año: 2024 Tipo del documento: Article País de afiliación: Perú Pais de publicación: Perú
Buscar en Google
Añadir a Mi BVS
Imprimir
XML
PubMed Links

Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Úlcera Péptica Hemorrágica / Hemostasis Endoscópica / Segunda Cirugía Límite: Humans Idioma: En Revista: Rev Gastroenterol Peru Asunto de la revista: GASTROENTEROLOGIA Año: 2024 Tipo del documento: Article País de afiliación: Perú Pais de publicación: Perú