BACKGROUND AND STUDY AIMS: A meta-analysis was conducted to assess the efficacy of transcatheter @entity1416 (TAE) compared with surgery in the management of @entity1 with recurrent @entity360 ( @entity360 ) after failure of endoscopic hemostasis. @entity1 AND METHODS: Publications in English and non-English literatures (OVID, MEDLINE, and EMBASE) and abstracts from major international conferences were searched for studies comparing TAE with surgery for treatment of @entity360 after @entity177 . Outcome measures included rebleeding rate, all-cause mortality rate, and need for additional interventions to secure hemostasis. RESULTS: From 1234 citations, 6 retrospective comparative studies were included that involved 423 @entity1 (TAE, 182, 56% male; surgery, 241, 68% male). TAE @entity1 were older (mean age, TAE 75, surgery, 68). The risk of rebleeding was significantly higher in TAE @entity1 compared with surgically treated @entity1 (relative risk [RR] 1.82, 95% confidence interval [95%CI] 1.23-2.67), with no statistically significant heterogeneity among the included studies (P=0.66, I (2)=0.0%). After sensitivity analysis excluding studies with a large age difference between the two groups, a higher risk of @entity548 remained in the TAE group (RR 2.64, 95%CI] 1.48-4.71). No significant difference in mortality (RR 0.87, 95%CI 0.59-1.29) or requirement for additional interventions (RR 1.67, 95%CI 0.75-3.70) was shown between the two groups. CONCLUSION: A higher rebleeding rate was observed after TAE, suggesting surgery more definitively secured hemostasis, with no significant difference in mortality rate or requirement of additional interventions. The TAE @entity1 were older and in poorer health, thus future randomized studies are needed for accurate comparison of the two modalities.

Embolization versus surgery for peptic ulcer XXXX after failed endoscopic hemostasis: a meta-analysis.

@entity1 :: ('9606', 'Species') :: ['patients', 'PATIENTS'] @entity548 :: ('MESH:D006470', 'Disease') :: ['bleeding'] @entity1416 :: ('MESH:D020762', 'Disease') :: ['arterial embolization'] @entity177 :: ('MESH:D051437', 'Disease') :: ['endoscopic hemostasis failure'] @entity360 :: ('MESH:D006471', 'Disease') :: ['NVUGIB', 'nonvariceal upper gastrointestinal bleeding']
@entity548 :: (MESH:D006470,Disease) :: ['bleeding']
