The efficacy and safety of glucocorticoid for perioperative patients with hepatectomy: a systematic review and meta-analysis
Yang, KH (通讯作者),Lanzhou Univ, Evidence Based Med Ctr, Sch Basic Med Sci, Lanzhou 730000, Gansu, Peoples R China.;Guo, TK (通讯作者),Gansu Prov Peoples Hosp, Dept Gen Surg, Lanzhou 730000, Gansu, Peoples R China.
ObjectiveGlucocorticoids have been used in patients undergoing perioperative hepatectomy, however their safety and efficacy remain controversial. This meta-analysis was conducted to investigate this issue and further provide reference for clinical practice.MethodsPubMed/MEDLINE, Embase, and Cochrane Library were searched for randomized controlled trials (RCTs) from database inception to December 2022. Literature screening and data extraction were performed independently by two reviewers. The methodological quality of the RCTs was assessed using the Jadad scale. RevMan 5.4 was used for the meta-analysis.ResultsA total of 11 RCTs involving 905 patients were included. Compared with the control group, we found perioperative glucocorticoid administration significantly lowered overall complication rate [RR = 0.67; 95% CI (0.55, 0.83); P = 0.0003], infectious complication rate [RR = 0.41; 95% CI (0.21, 0.82); P = 0.01] and postoperative liver failure [RR = 0.63; 95% CI (0.41, 0.97); P = 0.03]. In addition, glucocorticoids appear to improve liver function (TBil) [MD = -0.36, 95% CI (-0.59, -0.14), P = 0.001] and reduce the release of certain inflammatory cytokines (IL-6) [MD = -48.52, 95% CI (-56.88, -40.16), P ConclusionBased on the available evidence, glucocorticoids appear to be safe and effective in patients undergoing hepatectomy, but further research is needed.