Percutaneous catheter drainage versus percutaneous needle aspiration for liver abscess: a systematic review, meta-analysis and trial sequential analysis

ObjectiveTo compare the effectiveness and safety of percutaneous catheter drainage (PCD) against percutaneous needle aspiration (PNA) for liver abscess.DesignSystematic review, meta-analysis and trial sequential analysis.Data sourcesPubMed, Web of Science, Cochrane Library, Embase, Airiti Library an...

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Bibliographic Details
Published in:BMJ open 2023-07, Vol.13 (7), p.e072736-e072736
Main Authors: Lin, Jin-Wei, Chen, Chung-Ting, Hsieh, Ming-Shun, Lee, I-Hsin, Yen, David Hung-Tsang, Cheng, Hao-Min, Hsu, Teh-Fu
Format: Article
Language:English
Subjects:
Abscesses
Anti-Bacterial Agents - therapeutic use
Bias
Biopsy, Needle
Catheters
Drainage
Gastroenterology and Hepatology
Hospitals
Humans
Hypothesis testing
Liver
Liver Abscess - drug therapy
Meta-analysis
Mortality
public health
Software
Statistical analysis
Suction
Systematic review
Ultrasonic imaging
Variables
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Summary:ObjectiveTo compare the effectiveness and safety of percutaneous catheter drainage (PCD) against percutaneous needle aspiration (PNA) for liver abscess.DesignSystematic review, meta-analysis and trial sequential analysis.Data sourcesPubMed, Web of Science, Cochrane Library, Embase, Airiti Library and ClinicalTrials.gov were searched from their inception up to 16 March 2022.Eligibility criteriaRandomised controlled trials that compared PCD to PNA for liver abscess were considered eligible, without restriction on language.Data extraction and synthesisPrimary outcome was treatment success rate. Depending on heterogeneity, either a fixed-effects model or a random-effects model was used to derive overall estimates. Review Manager V.5.3 software was used for meta-analysis. Trial sequential analysis was performed using the Trial Sequential Analysis software. Certainty of evidence was evaluated using the Grading of Recommendations, Assessment, Development and Evaluation system.ResultsTen trials totalling 1287 individuals were included. Pooled analysis revealed that PCD, when compared with PNA, enhanced treatment success rate (risk ratio 1.16, 95% CI 1.07 to 1.25). Trial sequential analysis demonstrated this robust finding with required information size attained. For large abscesses, subgroup analysis favoured PCD (test of subgroup difference, p
ISSN:2044-6055
2044-6055
DOI:10.1136/bmjopen-2023-072736