Zhang Feng-Qin, Li Lin, Huang Ping-Chao, Fu Yu-Fei, Xu Qing-Song
Department of Ultrasound, Binzhou Medical University Hospital, Binzhou, China.
Department of Gynaecology, Binzhou People's Hospital, Binzhou, China.
Minim Invasive Ther Allied Technol. 2022 Jun;31(5):676-683. doi: 10.1080/13645706.2021.1986724. Epub 2021 Oct 11.
To compare the clinical effectiveness between transarterial embolization (TAE) with staged hepatectomy (SH) and emergency hepatectomy (EH) for ruptured hepatocellular carcinoma (HCC).
Pubmed, Embase, and Cochrane Library databases were screened for eligible publications from the inception of the databases till February 2021.
This meta-analysis included seven studies comprising 162 patients who underwent TAE with SH and 266 patients who underwent EH. The pooled intraoperative blood loss was less in the TAE with SH cohort, as compared to the EH cohort without significant difference ( = .20). The pooled blood transfer rate (<.00001), blood transfer volume ( = .002), and 30-day patient death ( = .04) were all markedly reduced in the TAE with SH cohort versus the EH cohort. No significant differences in surgery duration ( = .27), hospital stay period ( = .81), complication rate ( = 0.92), disease-free survival (DFS) ( = .79), and overall survival (OS) ( = 0.28) were found between the two groups.
Compared with EH for ruptured HCC, TAE with SH could effectively decrease intraoperative blood loss and 30-day mortality. However, the long-term DFS and OS might not be beneficial to preoperative TAE.
比较经动脉栓塞术（TAE）联合分期肝切除术（SH）与急诊肝切除术（EH）治疗破裂肝细胞癌（HCC）的临床疗效。
检索Pubmed、Embase和Cochrane图书馆数据库，筛选自数据库建立至2021年2月的符合条件的出版物。
该荟萃分析纳入了7项研究，包括162例行TAE联合SH的患者和266例行EH的患者。与EH队列相比，TAE联合SH队列的术中出血量汇总值较少，但差异无统计学意义（P = 0.20）。与EH队列相比，TAE联合SH队列的输血率（P < 0.00001）、输血量（P = 0.002）和30天患者死亡率（P = 0.04）均显著降低。两组在手术时间（P = 0.27）、住院时间（P = 0.81）、并发症发生率（P = 0.92）、无病生存期（DFS）（P = 0.79）和总生存期（OS）（P = 0.28）方面均未发现显著差异。
与EH治疗破裂HCC相比，TAE联合SH可有效减少术中出血量和30天死亡率。然而，长期DFS和OS可能对术前TAE无益处。
