Department of Interventional Radiology, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.
Department of Interventional Radiology, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.
J Vasc Interv Radiol. 2023 Dec;34(12):2110-2119.e1. doi: 10.1016/j.jvir.2023.08.033. Epub 2023 Aug 29.
To assess the reported safety and effectiveness of sclerotherapy for the treatment of nonparasitic splenic cysts through a systematic review and meta-analysis.
A systematic search of PubMed MEDLINE, Embase, Web of Science, and the Cochrane Library through July 2023 was performed. Studies including at least 5 patients reporting percutaneous sclerotherapy of nonparasitic splenic cysts, initial and posttreatment cyst size, clinical symptoms as well as adverse events (AEs), and recurrence rates were included. A 0-8-point scale for case reports and case series was used to assess bias. Data were analyzed using random-effects meta-analysis.
Twenty-three of 833 citations were selected for full-text assessment, and 7 studies were included for a total of 99 patients. The methodological quality of the studies included scored 3-7. Composite analysis demonstrated 38% (95% CI, 23%-55%) rate of recurrence after treatment with significant heterogeneity; however, when assessed for a cyst size of <8 cm, recurrence dropped to 7% (95% CI, 2%-20%). Residual symptoms after treatment completion were present in 17% (95% CI, 7%-33%). Intraprocedural and postprocedural AE rates were 6% (95% CI, 3%-13%) and 6% (95% CI, 3%-12%) respectively.
Sclerotherapy of splenic cysts seemed to be safe, with a high rate of recurrence for cysts ≥8 cm.
通过系统评价和荟萃分析评估硬化疗法治疗非寄生虫性脾囊肿的安全性和有效性。
对 2023 年 7 月前的 PubMed MEDLINE、Embase、Web of Science 和 Cochrane 图书馆进行了系统检索。纳入至少包含 5 例患者、报告经皮硬化治疗非寄生虫性脾囊肿、初始和治疗后囊肿大小、临床症状和不良事件(AE)以及复发率的研究。使用病例报告和病例系列的 0-8 分量表评估偏倚。使用随机效应荟萃分析对数据进行分析。
在 833 条引文中有 23 条被选作全文评估,其中 7 项研究共纳入 99 例患者。纳入研究的方法学质量评分为 3-7 分。综合分析显示,治疗后复发率为 38%(95%CI,23%-55%),但当评估囊肿大小<8cm 时,复发率降至 7%(95%CI,2%-20%)。治疗完成后仍存在残留症状的患者占 17%(95%CI,7%-33%)。术中及术后 AE 发生率分别为 6%(95%CI,3%-13%)和 6%(95%CI,3%-12%)。
硬化疗法治疗脾囊肿似乎是安全的,但对于≥8cm 的囊肿复发率较高。