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©2011 Baishideng Publishing Group Co.
World J Gastroenterol. Jul 14, 2011; 17(26): 3158-3164
Published online Jul 14, 2011. doi: 10.3748/wjg.v17.i26.3158
Published online Jul 14, 2011. doi: 10.3748/wjg.v17.i26.3158
Table 1 Characteristics of randomized controlled trials comparing total hepatic inflow occlusion with hemihepatic vascular occlusion
Author (yr) | Design | Sample size (n) | THO (n) | HHO (n) | Journal | Comparison |
Figueras et al (2005) | RCT | 80 | 39 | 41 | Annals of Surgery | Complete vs selective portal triad clamping |
Wu et al (2002) | RCT | 58 | 28 | 30 | Arch Surg | Hemihepatic vs total hepatic occlusion techniques |
Yuan et al (2010) | RCT | 120 | 60 | 60 | The American Journal of Surgery | Pringle maneuver vs hemihepatic vascular occlusion |
Liang et al (2009) | RCT | 80 | 40 | 40 | Hepato-Gastroen-terology | Continuous hemihepatic with intermittent total hepatic inflow occlusion |
Total | -- | 338 | 167 | 171 | -- | -- |
Table 2 Characteristics of patients in randomized controlled trials comparing total hepatic inflow occlusion with hemihepatic vascular occlusion
Author (yr) | Age | Sex | Cirrhosis | Ischaemic | Resection margin ( ≤ 1 segments:≥ 2 segments) THO/HHO | Diseases |
(mean yr) | (male:female) | (n:N) | preconditioning | HCC: Others | ||
THO/HHO | THO/HHO | THO/HHO | THO/HHO | |||
Figueras et al (2005) | 61.8/62 | 31:8/28:13 | 18:39/21:41 | IC | 25:14/29:12 | 16:23/17:24 |
Wu et al (2002) | 57.5/53.2 | 23:5/25:5 | 28:28/30:30 | IC | 5:23/7:23 | 25:3/26:4 |
Yuan et al (2010) | 48.6/49.3 | 46:14/41:19 | 39:60/35:60 | IC if transaction time > 30 min or CC | 5:55/5:55 | 44:16/43:17 |
Liang et al (2009) | 49.4/49.55 | 27:13/31:9 | 17:40/19:40 | IC or CC | 6:34/10:30 | 20:20/21:19 |
Total | -- | 127:40/125:46 | 102:167/105:171 | -- | 41:126/51:120 | 105:62/107:64 |
Table 3 Outcomes of randomized controlled trials comparing total hepatic inflow occlusion with hemihepatic vascular occlusion
Author (yr) | Operative time (min) | Ischemic duration (min) | Blood loss (mL) | Transfusion requirements | Complications total (n) | In-hospital stay (d) | In-hospital death (n) |
THO/HHO | THO/HHO | THO/HHO | THO/HHO | THO/HHO | THO/HHO | THO/HHO | |
Figueras et al (2005) | 207 ± 48/219 ± 45 | 41 ± 14/47 ± 18 | 671 ± 533/735 ±397 | 4:39/6:41 | 15:39/ 12:41 | 9.38 ± 4.9/8.15 ± 3.8 | 0:39/1:41 |
Wu et al (2002) | 409 ± 19.2/ 399 ± 15.6 | 96.0 ± 10.9/ 94.2 ± 9.9 | 1685 ± 170/ 1159 ± 221 | 12:28/5:30 | 8:28/10:30 | 14.8 ± 1.4/16.4 ± 1.4 | 0:28/0:30 |
Yuan et al (2010) | 114.2 ± 37.2/ 133.5 ± 44.6 | 16.6 ± 8.7/ 14.9 ± 4.5 | 339.5 ± 205.1/ 354.4 ± 240.3 | 6:60/4:60 | 19:60/12:60 | 13.7 ± 5.2/10.2 ±4.1 | 1:60/0:60 |
Liang et al (2009) | 203.98 ± 38.36/ 236.15 ± 49.2 | 40.17 ± 13.30/ 42.38 ± 12.79 | 569.8 ± 285.56/ 649.35 ± 279.05 | 14:40/15:40 | 8:40/9:40 | 9.85 ± 3.55/10.12 ± 2.41 | 0:40/0:40 |
Total | -- | -- | -- | 36:167/30:171 | 50:167/43:171 | -- | 1:167/1:171 |
Table 4 Postoperative aspartate aminotransferase and alanine aminotransferase levels of patients in randomized controlled trials comparing total hepatic inflow occlusion with hemihepatic vascular occlusion
Author (yr) | AST (U/L) | AST (U/L) | AST (U/L) | ALT (U/L) | ALT (U/L) | ALT (U/L) |
Day 1 | Day 3 | Day 7 | Day 1 | Day 3 | Day 7 | |
THO/HHO | THO/HHO | THO/HHO | THO/HHO | THO/HHO | THO/HHO | |
Wu et al (2002) | 420 ± 790/290 ± 770 | 180 ± 320/190 ± 510 | 50 ± 40/30 ± 20 | 370 ± 490/480 ± 510 | 330 ± 320/320 ± 270 | 90 ± 20/70 ± 20 |
Yuan et al (2010) | 812.6 ± 475.3/447.6 ±210.3 | 423.7 ± 265.4/207.5 ± 79.3 | 143.6 ± 87.5/64.2 ± 29.4 | 1013.6 ± 654.4/369.4 ± 347.2 | 592.2 ± 416.4/218.4 ± 185.3 | 172.4 ± 125.8/ 79.6 ± 55.3 |
Figueras et al (2005) | NS | NS | NS | 402 ± 258/372 ± 234 | NS | NS |
Table 5 Assessment the methodological quality of included studies
Author (yr) | Sample size calculation | Generation of allocation sequence | Allocation concealment | Deviations, withdrawals and dropouts | Efficacy of randomization | Blinding | Definition of outcome parameters |
Figueras et al (2005) | Yes | No description | Sealed envelope | Yes | Yes | No description | Yes |
Wu et al (2002) | No description | No description | Sealed envelope | No description | Yes | No description | Yes |
Yuan et al (2010) | Yes | Yes | Sealed envelope | Yes | Yes | Single-blinded | No description |
Liang et al (2009) | No description | No description | No description | Yes | Yes | No description | Yes |
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Citation: Wang HQ, Yang JY, Yan LN. Hemihepatic
versus total hepatic inflow occlusion during hepatectomy: A systematic review and meta-analysis. World J Gastroenterol 2011; 17(26): 3158-3164 - URL: https://www.wjgnet.com/1007-9327/full/v17/i26/3158.htm
- DOI: https://dx.doi.org/10.3748/wjg.v17.i26.3158