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Pediatric Surgery International

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01-12-2021 | Gastrointestinal Bleeding | Original Article

Meso-Rex bypass versus portosystemic shunt for the management of extrahepatic portal vein obstruction in children: systematic review and meta-analysis

Authors: Masaya Yamoto, Sinobol Chusilp, Mashriq Alganabi, Blayne Amir Sayed, Agostino Pierro

Published in: Pediatric Surgery International | Issue 12/2021

Abstract

Purpose

Extrahepatic portal vein obstruction (EHPVO) is a major cause of non-cirrhotic portal hypertension in children. Surgical procedures for EHPVO include portosystemic shunts (PSS) and meso-Rex bypass (MRB). We conducted a systematic review and meta-analysis to compare the effectiveness of MRB versus PSS in EHPVO patients.

Methods

A systematic literature search was performed using four databases. Articles reporting EHPVO and comparing patients who received MRB and PSS were included in the analysis.

Results

We retrieved 851 papers, of which five observational studies met the inclusion criteria. There was no difference in shunt complications, mortality, or gastrointestinal bleeding after surgery between MRB and PSS in the meta-analysis. MRB had increased shunt complications compared with PSS in the non-comparative studies. MRB had a potential advantage over PSS in long-term prognosis in one comparative study. Overall, the quality of the evidence was low.

Conclusions

Based on available data, our meta-analysis indicates that MRB does not increase shunt complications, mortality, or gastrointestinal bleeding after surgery. The present study did not reveal superiority for either MRB or PSS. The paucity of well conducted trials in this area justifies future multicenter studies and studies that examine long-term outcomes.

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Title: Meso-Rex bypass versus portosystemic shunt for the management of extrahepatic portal vein obstruction in children: systematic review and meta-analysis
Authors: Masaya Yamoto
Sinobol Chusilp
Mashriq Alganabi
Blayne Amir Sayed
Agostino Pierro
Publication date: 01-12-2021
Publisher: Springer Berlin Heidelberg
Keywords: Gastrointestinal Bleeding
Portal Hypertension
Portal Hypertension
Published in: Pediatric Surgery International / Issue 12/2021
Print ISSN: 0179-0358
Electronic ISSN: 1437-9813
DOI: https://doi.org/10.1007/s00383-021-04986-z

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Meso-Rex bypass versus portosystemic shunt for the management of extrahepatic portal vein obstruction in children: systematic review and meta-analysis

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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