The efficacy of ischemic conditioning in the prevention of gastroesophageal anastomotic complications: a meta-analysis.

Annals of Palliative Medicine
Ze-Guo ZhuoYi-Dan Lin

Abstract

The blood supply to the gastric conduit is thought to be the most crucial factor affecting the healing of the gastroesophageal anastomosis. By selective ligation or embolization of gastric vessels, ischemic conditioning (IC) could promote the hypertrophy and neovascularization of the remaining gastric vessels. So that it could help the stomach adapt to the decline of blood supply before esophagectomy. However, the safety and efficacy of the technique still needs to be proved. Several new studies on this topic have been published recently. We conduct this meta-analysis to update the evidence on this topic. A logistic searching strategy was designed to find out related publications on four medical databases (PubMed, EMBASE, Medline, and Cochrane Central Register of controlled trials). The included studies were confirmed by reading the title, abstract, or full text. Based on these included studies, the comparison of postoperative outcomes between patients who received IC and those did not was made. After that, the safety and efficacy of IC were assessed. Fourteen studies were enrolled in the meta-analysis. The pooled analysis showed IC reduced the incidence of anastomotic leakage significantly. And both the embolization and laparo...Continue Reading

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