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• W2808682714 abstract "Step-up therapy is the recommended therapy for infected necrotizing pancreatitis (INP). However, the most appropriate secondary therapy for use after initial drainage has not been fully determined. This meta-analysis was designed to evaluate the efficacy and safety of retroperitoneal versus open intraperitoneal necrosectomy as part of a step-up strategy for INP. Eight online databases were searched for randomized controlled trials (RCTs) and cohorts comparing retroperitoneal and open intraperitoneal step-up approaches for treating INP. The data was pooled with a random-effects model. A total of 21 controlled studies (one RCT and twenty cohorts) and 2177 patients were included in this study. Our meta-analysis showed that the retroperitoneal group had a lower postoperative complication rate [risk ratio (RR) = 0.575, 95% confidence interval (CI) = 0.459 to 0.719, P < 0.001], lower postoperative mortality (RR = 0.525, 95% CI = 0.430 to 0.642, P < 0.001), higher technical success rate (RR = 1.313, 95% CI = 1.017 to 1.694, P = 0.037), similar surgical reintervention rate (RR = 0.930, 95% CI = 0.783 to 1.106, P = 0.411), shorter operative time [standardized mean difference (SMD) = −2.402, 95% CI = −3.642 to −1.161, P < 0.001], and shorter hospital stay (SMD = −2.034, 95% CI = −3.041 to −1.026, P < 0.001) than the open group. These results were supported by a subgroup analysis. For treating INP, the retroperitoneal approach is safer and more effective than the open intraperitoneal approach." @default.
• W2808682714 created "2018-06-21" @default.
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• W2808682714 date "2018-08-01" @default.
• W2808682714 modified "2023-09-27" @default.
• W2808682714 title "Retroperitoneal versus open intraperitoneal necrosectomy in step-up therapy for infected necrotizing pancreatitis: A meta-analysis" @default.
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• W2808682714 doi "https://doi.org/10.1016/j.ijsu.2018.06.012" @default.
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