Huan Wei, Wenyuan Gan, Changxuan Liu, Wenli Chen
Medical School, Jianghan University, China.
Department of Nephrology, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, China.
J Int Med Res. 2025 May;53(5):3000605251340162. doi: 10.1177/03000605251340162. Epub 2025 May 25.
ObjectiveThis study aimed to evaluate the effect of surgical versus nonsurgical treatment on mortality in patients with encapsulating peritoneal sclerosis who underwent peritoneal dialysis.MethodsA comprehensive search using PubMed, Google Scholar, MEDLINE, Science Direct, Scopus, and CNKI databases was conducted to extract relevant data based on predefined inclusion criteria. RevMan5.2 was applied to analyze and compare the effect of surgical versus nonsurgical treatment on mortality in patients with encapsulating peritoneal sclerosis who underwent peritoneal dialysis.ResultsA total of 7 studies involving 70 surgical and 57 nonsurgical patients were included, with 61.4% females and 38.6% males. Among them, 69 were Asian and 58 were European patients, with 37.7% and 75.9% of Asian and European patients accepting surgical treatment, respectively. Pooled data analysis indicated that surgical treatment was associated with significantly lower mortality than nonsurgical treatment in patients with encapsulating peritoneal sclerosis (odds ratio = 0.25, 95% confidence interval: 0.11-0.57, Z = 3.29; =0.001). Subgroup analysis revealed that Asian patients who accepted surgical treatment had significantly lower mortality than those receiving nonsurgical treatment (odds ratio = 0.19, 95% confidence interval: 0.06-0.57, Z = 2.93; =0.003), whereas no significant difference was observed in mortality between surgical and nonsurgical treatments in European patients (odds ratio = 0.38, 95% confidence interval: 0.10-1.41, Z = 1.45; =0.15).ConclusionsSurgical treatment was associated with reduced mortality in patients with encapsulating peritoneal sclerosis compared with nonsurgical treatment; however, this benefit was more significant in Asian patients than in European patients.
目的
本研究旨在评估手术治疗与非手术治疗对接受腹膜透析的包裹性腹膜硬化患者死亡率的影响。
方法
通过使用PubMed、谷歌学术、MEDLINE、科学Direct、Scopus和中国知网数据库进行全面检索，根据预先定义的纳入标准提取相关数据。应用RevMan5.2分析并比较手术治疗与非手术治疗对接受腹膜透析的包裹性腹膜硬化患者死亡率的影响。
结果
共纳入7项研究，涉及70例手术治疗患者和57例非手术治疗患者，其中女性占61.4%，男性占38.6%。其中，69例为亚洲患者，58例为欧洲患者，亚洲和欧洲患者接受手术治疗的比例分别为37.7%和75.9%。汇总数据分析表明，在包裹性腹膜硬化患者中，手术治疗的死亡率显著低于非手术治疗（优势比=0.25，95%置信区间：0.11-0.57，Z=3.29；P=0.001）。亚组分析显示，接受手术治疗的亚洲患者死亡率显著低于接受非手术治疗的患者（优势比=0.19，95%置信区间：0.06-0.57，Z=2.93；P=0.003），而欧洲患者手术治疗和非手术治疗的死亡率无显著差异（优势比=0.38，95%置信区间：0.10-1.41，Z=1.45；P=0.15）。
结论
与非手术治疗相比，手术治疗可降低包裹性腹膜硬化患者的死亡率；然而，这种益处在亚洲患者中比在欧洲患者中更为显著。
