Metanálise sobre o uso de glicocorticóide pré-operatório para redução do risco de complicações após esofagectomia por carcinoma do esôfago

Metanálise sobre o uso de glicocorticóide pré-operatório para redução do risco de complicações após esofagectomia por carcinoma do esôfago

Alternative title Use of preoperative glucocorticoid to reduce risk of complications after esophagectomy for carcinoma of the esophagus: meta-analysis
Author Raimondi, Antônio Marcos Autor UNIFESP Google Scholar
Institution Univ Ribeirao Preto
Universidade Federal de São Paulo (UNIFESP)
Abstract OBJECTIVE. Preoperative glucocorticoid administration has been proposed to reduce postoperative morbidity. This is not frequently done before esophageal resection because of insufficient knowledge on its effectiveness. The purpose was to assess the effects of preoperative glucocorticoid administration in adults undergoing esophageal resection for esophageal carcinoma.METHODS. Studies were identified by searching the Cochrane Controlled Trials Register, Medline, Embase, Scielo and Cochrane Library, and by a manual search for relevant articles. In this systematic review, the lost search for clinical trials was performed in December 2005. This review included randomized studies of patients with potentially resectable carcinomas of the esophagus that compared preoperative glucocorticoid administration with placebo. Data were collected by the reviewer, and quality of the trial was assessed using jadad scoring. Odds ratio with 95% confidence intervals was used to assess the significance of the difference between treatment arms.RESULTS. Four randomized trials involving 169 patients were found. There were no differences in postoperative mortality, anastomotic leakage, hepatic end renal failure between the glucocorticoid and placebo groups. There were fewer postoperative respiratory complications (95% CI = 0.09-0.46), sepsis (95% CI = 0.10-0.81), and total postoperative complications (95% CI=0.06-0.23) with preoperative glucocorticoid administration.Conclusion. Prophylactic administration of glucocorticoids is associated with decreased postoperative complications.
Keywords review literature
multiple organ failure
Language Portuguese
Date 2007-03-01
Published in Revista Da Associacao Medica Brasileira. Sao Paulo: Assoc Medica Brasileira, v. 53, n. 2, p. 158-161, 2007.
ISSN 0104-4230 (Sherpa/Romeo, impact factor)
Publisher Assoc Medica Brasileira
Extent 158-161
Access rights Open access Open Access
Type Article
Web of Science ID WOS:000254538400022
SciELO ID S0104-42302007000200022 (statistics in SciELO)

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