Does the Intermittent Pringle Maneuver Affect the Recurrence Following Surgical Resection for Hepatocellular Carcinoma? A Systematic Review

Overview

Journal PLoS One

Specialties General Medicine
Science

Date 2020 Mar 12

PMID 32160231

Citations 5

Authors

Nanping Lin

Jingrong Li

Qiao Ke

Fuli Xin

Yongyi Zeng

Lei Wang

Jingfeng Liu

Affiliations

Soon will be listed here.

Abstract

Background And Aim: To evaluate the effect of intermittent pringle maneuver (IPM) on the long-term prognosis and recurrence of hepatocellular carcinoma (HCC).

Methods: Eligible studies were identified by PubMed and other databases from Jan 1st 1990 to Mar 31st 2019. Hazard ratios (HR) with 95% confidence interval (CI) were calculated to evaluate the effects of IPM on the long-term prognosis and recurrence of patients with HCC.

Results: Six studies were enrolled in this meta-analysis. Results showed that there were no differences between IPM group and non-IPM group in the pooled HRs for the overall survival (OS) and disease-free survival (DFS) (HR 1.04, 95%CI 0.84~1.28, P = 0.74; HR 0.93, 95%CI 0.81~1.07, P = 0.29; respectively). However, subgroup analysis showed that the pooled Odd ratios (OR) for the 1-year OS and DFS rates of the IPM group when compared with the non-IPM group were 0.65 (95% CI 0.45~0.94, P = 0.02), 0.38 (95% CI 0.20~0.72, P = 0.003), respectively. In addition, there were no significant differences in the proportions of liver cirrhosis, HBsAg (+), Child-Pugh A class, multiple tumor, vascular invasion, and major hepatectomy between groups of IPM and non-IPM.

Conclusion: Since IPM would increase the risk of early-recurrence, it should be used cautiously in the procedure of hepatectomy for resectable HCC. However, the current conclusion needs further validation.

Trial Registry Number: CRD 42019124923.

Citing Articles

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