Effect of intermittent Pringle maneuver on perioperative outcomes and long-term survival following liver resection in patients with hepatocellular carcinoma: a meta-analysis and systemic review
Abstract Background Intermittent Pringle maneuver (IPM) is commonly used to control bleeding during liver resection. IPM can cause ischemia–reperfusion injury, which may affect the prognosis of patients with hepatocellular carcinoma (HCC). The present meta-analysis was conducted to evaluate the effe...
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| Format: | Article |
| Language: | English |
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BMC
2023-11-01
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| Series: | World Journal of Surgical Oncology |
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| Online Access: | https://doi.org/10.1186/s12957-023-03244-x |
| _version_ | 1797452456187133952 |
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| author | Lingbo Hu Aidong Wang Yingli Qiao Xiandan Huang |
| author_facet | Lingbo Hu Aidong Wang Yingli Qiao Xiandan Huang |
| author_sort | Lingbo Hu |
| collection | DOAJ |
| description | Abstract Background Intermittent Pringle maneuver (IPM) is commonly used to control bleeding during liver resection. IPM can cause ischemia–reperfusion injury, which may affect the prognosis of patients with hepatocellular carcinoma (HCC). The present meta-analysis was conducted to evaluate the effect of IPM use on perioperative outcomes and long-term survival in patients with HCC. Methods A systemic literature search was performed in the PubMed, Embase, Web of Science, and Cochrane Library databases to identify randomized controlled trials and retrospective studies that compared the effect of IPM with no Pringle maneuver during liver resection in patients with HCC. Hazard ratio (HR), risk ratio, standardized mean difference, and their 95% confidence interval (CI) values were calculated based on the type of variables. Results This meta-analysis included nine studies comprising one RCT and eight retrospective studies and involved a total of 3268 patients. Perioperative outcomes, including operation time, complications, and length of hospital stay, except for blood loss, were comparable between the two groups. After removing the studies that led to heterogeneity, the results showed that IPM was effective in reducing blood loss. Five studies reported overall survival (OS) and disease-free survival (DFS) data and eight studies reported perioperative outcomes. No significant difference in OS and DFS was observed between the two groups (OS: HR, 1.01; 95% CI, 0.85–1.20; p = 0.95; DFS: HR, 1.01; 95% CI, 0.88–1.17; p = 0.86). Conclusion IPM is a useful technique to control blood loss during liver resection and does not affect the long-term survival of patients with HCC. |
| first_indexed | 2024-03-09T15:09:02Z |
| format | Article |
| id | doaj.art-975c8628f95745d8baa375eadd6735d2 |
| institution | Directory Open Access Journal |
| issn | 1477-7819 |
| language | English |
| last_indexed | 2024-03-09T15:09:02Z |
| publishDate | 2023-11-01 |
| publisher | BMC |
| record_format | Article |
| series | World Journal of Surgical Oncology |
| spelling | doaj.art-975c8628f95745d8baa375eadd6735d22023-11-26T13:31:40ZengBMCWorld Journal of Surgical Oncology1477-78192023-11-0121111010.1186/s12957-023-03244-xEffect of intermittent Pringle maneuver on perioperative outcomes and long-term survival following liver resection in patients with hepatocellular carcinoma: a meta-analysis and systemic reviewLingbo Hu0Aidong Wang1Yingli Qiao2Xiandan Huang3Department of Hepatopancreatobiliary Surgery, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical UniversityDepartment of Hepatopancreatobiliary Surgery, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical UniversityDepartment of Hepatopancreatobiliary Surgery, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical UniversityDepartment of Hepatopancreatobiliary Surgery, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical UniversityAbstract Background Intermittent Pringle maneuver (IPM) is commonly used to control bleeding during liver resection. IPM can cause ischemia–reperfusion injury, which may affect the prognosis of patients with hepatocellular carcinoma (HCC). The present meta-analysis was conducted to evaluate the effect of IPM use on perioperative outcomes and long-term survival in patients with HCC. Methods A systemic literature search was performed in the PubMed, Embase, Web of Science, and Cochrane Library databases to identify randomized controlled trials and retrospective studies that compared the effect of IPM with no Pringle maneuver during liver resection in patients with HCC. Hazard ratio (HR), risk ratio, standardized mean difference, and their 95% confidence interval (CI) values were calculated based on the type of variables. Results This meta-analysis included nine studies comprising one RCT and eight retrospective studies and involved a total of 3268 patients. Perioperative outcomes, including operation time, complications, and length of hospital stay, except for blood loss, were comparable between the two groups. After removing the studies that led to heterogeneity, the results showed that IPM was effective in reducing blood loss. Five studies reported overall survival (OS) and disease-free survival (DFS) data and eight studies reported perioperative outcomes. No significant difference in OS and DFS was observed between the two groups (OS: HR, 1.01; 95% CI, 0.85–1.20; p = 0.95; DFS: HR, 1.01; 95% CI, 0.88–1.17; p = 0.86). Conclusion IPM is a useful technique to control blood loss during liver resection and does not affect the long-term survival of patients with HCC.https://doi.org/10.1186/s12957-023-03244-xPringle maneuverLiver resectionHepatocellular carcinomaLong-term survivalMeta-analysis |
| spellingShingle | Lingbo Hu Aidong Wang Yingli Qiao Xiandan Huang Effect of intermittent Pringle maneuver on perioperative outcomes and long-term survival following liver resection in patients with hepatocellular carcinoma: a meta-analysis and systemic review World Journal of Surgical Oncology Pringle maneuver Liver resection Hepatocellular carcinoma Long-term survival Meta-analysis |
| title | Effect of intermittent Pringle maneuver on perioperative outcomes and long-term survival following liver resection in patients with hepatocellular carcinoma: a meta-analysis and systemic review |
| title_full | Effect of intermittent Pringle maneuver on perioperative outcomes and long-term survival following liver resection in patients with hepatocellular carcinoma: a meta-analysis and systemic review |
| title_fullStr | Effect of intermittent Pringle maneuver on perioperative outcomes and long-term survival following liver resection in patients with hepatocellular carcinoma: a meta-analysis and systemic review |
| title_full_unstemmed | Effect of intermittent Pringle maneuver on perioperative outcomes and long-term survival following liver resection in patients with hepatocellular carcinoma: a meta-analysis and systemic review |
| title_short | Effect of intermittent Pringle maneuver on perioperative outcomes and long-term survival following liver resection in patients with hepatocellular carcinoma: a meta-analysis and systemic review |
| title_sort | effect of intermittent pringle maneuver on perioperative outcomes and long term survival following liver resection in patients with hepatocellular carcinoma a meta analysis and systemic review |
| topic | Pringle maneuver Liver resection Hepatocellular carcinoma Long-term survival Meta-analysis |
| url | https://doi.org/10.1186/s12957-023-03244-x |
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