Percutaneous endoscopic debridement and irrigation for thoracic infections

Xu, Zhongyang; Zheng, Yanping

doi:10.1590/1806-9282.64.06.518

Cited by 4 publications

(2 citation statements)

References 18 publications

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“…Among 1,581 retrieved searched articles, 9 singlearm PEDD articles (7)(8)(9)(10)(11)(15)(16)(17)(18) were with a total of 158 included patients (Fig. 1).…”

Section: Eligible Studies and Characteristics Of Studiesmentioning

confidence: 99%

Percutaneous Endoscopic Debridement and Drainage for Spinal Infection: Systemic Review and Meta-Analysis

Cui

2019

Pain Phys

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Background: Percutaneous endoscopic debridement and drainage (PEDD) has played a vital role in the management of spinal infection; however, limited PEDD results are available to date. Objectives: The purpose of this systematic review is to examine the existing literature, to give an objective estimate of the outcomes of PEDD using a meta-analytical approach. Study Design: Meta-analysis and systematic review of retrospective single-arm studies. Methods: A comprehensive online review was performed in MEDLINE, EMBASE, PubMed, Web of Science, and Cochrane databases from 1980 to October 2018. Eligible studies included the singlearm studies that mentioned PEDD in the management of spinal infection. Pooled event rates for positive bacteria culture, pain control satisfaction, and reoperation were estimated. The complications of PEDD were also recorded. Results: Nine single-arm PEDD articles (158 patients) were included. The pooled event rate was 82% (95% CI: 75%-88%) for positive bacteria culture, 81% (95% CI: 73%-87%) for pain control satisfaction, and 21% (95% CI: 15%-29%) for reoperation. There are few complications reported in the literature that included transient paresthesia in the affected lumbar segment and local kyphosis. Limitations: First, all included studies were retrospective series with inherent methodological limitations. Second, the sample size and the number of studies that were found to be eligible was small. In addition, all included studies are single-arm, and further studies are necessary in large randomized controlled trials on comparing the efficacy of conservative therapy, PEDD, and open surgical intervention. Conclusions: PEDD not only has a high rate of causative-pathogen identification, but also provides satisfactory clinical outcome. Early PEDD intervention in spinal infection is encouraging; however, further studies in large randomized controlled trials on comparing the efficacy of conservative therapy, PEDD, and open surgical intervention are necessary. Key words: Percutaneous endoscopic debridement and drainage, spinal infection, meta-analysis

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“…Among 1,581 retrieved searched articles, 9 singlearm PEDD articles (7)(8)(9)(10)(11)(15)(16)(17)(18) were with a total of 158 included patients (Fig. 1).…”

Section: Eligible Studies and Characteristics Of Studiesmentioning

confidence: 99%

Percutaneous Endoscopic Debridement and Drainage for Spinal Infection: Systemic Review and Meta-Analysis

Cui

2019

Pain Phys

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“…Surgery and digestive endoscopy treatments can both utilize the ascending steps method. Essentially, this involves further endoscopic debridement being applied when a patient's surgery proves ineffective (10). However, there are relatively few studies on the effectiveness and safety of digestive endoscopy and surgery in the treatment of necrotizing pancreatitis, with most of these being retrospective analyses.…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of digestive endoscopy and surgery in the treatment of necrotizing pancreatitis: a meta-analysis and systematic review

Tang¹,

Zha²,

Zhou³

et al. 2021

Gland Surg

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Background: Digestive endoscopy and surgery are the primary invasive methods for the clinical treatment of necrotizing pancreatitis. However, there are relatively few studies evaluating the effectiveness and safety of these two methods. Methods: Randomized controlled trials (RCTs) on endoscopic and surgical treatment of necrotizing pancreatitis published from January 2000 to December 2020 were searched in the PubMed, Medline, Embase, China Biology Medicine Disc (CBM), and WanFang databases. The Cochrane System Review Manual was adopted to evaluate the quality of the included literature, and Review Manager 5.3 was used for data analysis. Results: Ten articles were included in this meta-analysis, involving a total of 401 patients, including 188 in the endoscopy group and 213 in the surgery group. Meta-analysis results revealed that the clinical remission rate (CRR) [odds ratio (OR) =1.30, 95% confidence interval (CI): 0.58-2.92, P=0.52], new organ failure rate (OFR) (OR =0.53, 95% CI: 0.26-1.09, P=0.08), abdominal bleeding rate (ABR) (OR =0.62, 95% CI: 0.33-1.15, P=0.13), and intensive care unit (ICU) stay time (IST) [mean deviation (MD) =−7.33, 95% CI: −16.76 to 2.11, P=0.13] were not significantly different between the endoscopy and surgery groups. In the endoscopy group, the mortality rate (OR =0.56, 95% CI: 0.31-1.02, P=0.05), intestinal fistula rate (IFR) or gastrointestinal perforation rate (GPR) (OR =0.50, 95% CI: 0.26-0.99, P=0.05), and pancreatic fistula rate (PFR) (OR =0.09, 95% CI: 0.04-0.23, P<0.00001) were markedly lower compared to the surgery group.Discussion: There was no obvious difference in the clinical efficacy of endoscopic and surgical treatment of necrotizing pancreatitis. However, endoscopy can greatly reduce the incidence of postoperative death and major complications in patients.

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