Percutaneous needle aspiration versus catheter drainage in the management of liver abscess: an updated systematic review and meta-analysis.

Autor: Al-Sayaghi KM; Department of Medical Surgical Nursing, College of Nursing, Taibah University, Al-Madinah Al-Munawarah, Saudi Arabia.; Nursing Division, Faculty of Medicine and Health Sciences, Sana'a University, Sana'a, Yemen., Alhujaily M; Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, University of Bisha, Bisha, Saudi Arabia., Zaky MK; Department of Surgery, College of Medicine, Taibah University, Al-Madinah Al-Munawarah, Saudi Arabia.; Department of Surgery, College of Medicine, Cairo University, Cairo, Egypt., Alhasan AS; Department of Radiology, College of Medicine, Taibah University, Medina, Saudi Arabia., Babikir TB; Department of Surgery, International Medical Center, Jeddah, Saudi Arabia., Alnehmi FS; Department of Radiology, Prince Mohammed Bin AbdulAziz Hospital, Ministry of National Guard Health Affairs, Medina, Saudi Arabia., Abdalrahman HH; College of Applied Medical Sciences, University of Hafr albatin, Hafr albatin, Saudi Arabia., Abdelmalik MAA; Department of Nursing, College of Applied Medical Sciences, Shaqra University, Shaqra, Saudi Arabia.; Faculty of Medicine and Health Sciences, Nursing, University of El Imam El Mahdi Kosti, Kosti, Sudan., Ali AM; College of Applied Medical Sciences, Shaqra University, Shaqra, Saudi Arabia., Fadlalmola HA; Department of Community Health Nursing, College of Nursing, Taibah University, Al-Madinah Al-Munawarah, Saudi Arabia., Swamy DSV; College of Applied Medical Science, Nursing Department, University of Bisha, Bisha, Saudi Arabia.
Jazyk: angličtina
Zdroj: ANZ journal of surgery [ANZ J Surg] 2023 Apr; Vol. 93 (4), pp. 840-850. Date of Electronic Publication: 2022 Oct 26.
DOI: 10.1111/ans.18129
Abstrakt: Background: Liver abscesses differ in their aetiology, location, and number. Image-guided percutaneous drainage techniques are the currently used management for liver abscesses. We conducted our study to compare the clinical safety and efficacy of percutaneous needle aspiration (PNA) to percutaneous catheter drainage (PCD).
Methods: A systematic review of major reference databases was undertaken in February 2022 for randomized controlled trials (RCTs) that compare PNA to PCD in treating liver abscess patients. The quality of the included trials was assessed using the Cochrane tool. Statistical meta-analysis was conducted using RevMan and open meta-analyst software.
Results: Fifteen RCTs were included in this review, with 1676 patients enrolled. The overall quality of the included trials was moderate, with most domains of unclear risk. PCD was superior to PNA in the success rate (RR = 1.23; 95% CI [1.12, 1.36], P < 0.00001), time for achieving 50% reduction of cavity size (MD = -2.32; 95% CI [-3.07, -1.57], P < 0.00001), and time for clinical improvement (MD = -1.92; 95% CI [-2.55, -1.28], P < 0.00001). The two modalities did not differ in the days of hospital stay, duration of IV antibiotics, and time needed for total or subtotal reduction of cavity size (P = 0.36, P = 0.06 and P = 0.40, respectively). High heterogeneity levels were detected. Regarding major complications, the two modalities were equally safe (P = 0.39).
Conclusion: PCD has a higher success rate and results in a faster 50% reduction in the abscess cavity size and clinical improvement. The two modalities are equally safe.
(© 2022 Royal Australasian College of Surgeons.)
Databáze: MEDLINE
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