Meta-analysis Of The Value Of Endoscopic Ultrasonography In Predicting Recurrence After Endoscopic Treatment Of Esophageal Varices

Research background and purpose:Esophageal varices are one of the main clinical manifestations of portal hypertension in liver cirrhosis.Currently,esophageal varices ligation is the preferred treatment,but the recurrence rate is high.The purpose of this article is to systematically evaluate the value of endoscopic ultrasonography in the prevention of lateral recurrence after radical resection of esophageal and gastric varices.Research methods:By searching the commonly used databases from 1990 to December 2021: CBM,Wanfang,CNKI,Pub Med and the cohort studies published in Web of Science,Cochrane Library,Web of Science,etc.,to analyze the recurrence and treatment after Esophageal and gastric varices endoscopic therapy The differences in endoscopic ultrasonography detection between the recurrence group and the non-recurrence group before and after surgery were statistically analyzed using Revman 5.3 software,and the relative risk odds ratio and effect size 95% confidence interval(confidence interval)were used for dichotomous variables.interval,CI)to evaluate different varicose vein detection conditions,perform sensitivity analysis and subgroup analysis,and generate RR forest plots with primary and secondary outcomes.Results:A total of 7 cohort studies met the inclusion and exclusion criteria,and 707 patients were included for statistical analysis,all of whom received endoscopic therapy,of which 608 received esophageal varices ligation,80 and 19 received Endoscopic injection sclerotherapy and esophageal varices ligation 、 Endoscopic injection sclerotherapy simultaneously,and surgery.Then,endoscopic ultrasonography was used to follow up for at least 1 year,and endoscopic ultrasonography was used to detect varicose veins before and after treatment,and the detection difference between the recurrence group and the non-recurrence group was compared.Significant difference(RR=0.86,95%[0.63,1.16],P=0.32),there is significant heterogeneity between studies(I2=87%),through sensitivity analysis,the literature was eliminated one by one,and it was found that in the elimination of After Jeong’s study,the heterogeneity was significantly reduced(P=0.05,I2=54%).Further subgroup analysis and publication bias detection were performed.The number of cases of multiple and peri-esophageal collateral branches was significantly higher than that of the non-recurrence group,with statistical significance(P<0.05),but there was no significant difference between the recurrent and non-recurrent groups with multiple para-esophageal collateral branches [(P>0.05,I2= 0);(RR=1.66,95% [0.99,2.79],P=0.06)].And the presence of perforating veins suggested a higher risk of recurrent bleeding [(P=0.001,I2=81%);(RR=3.32,95%[1.55,7.10],P=0.002)].There was a significant difference in F2 grade veins in the non-recurrence group compared with the recurrence group [(P=0.32,I2=12%);(RR=0.76,95%[0.60,0.97],P=0.03)],but no F3 grade veins were seen Significant difference [(P=0.11,I2=54%);(RR=1.62,95%[0.95,2.76],P=0.07)].Conclusions:1.There was no significant difference between the recurrence group and the non-recurrence group in the 1-year follow-up after endoscopic therapy.2.Before endoscopic treatment,the moderate and severe paraesophageal collateral veins and multiple and severe periesophageal collateral veins in the recurrence group were significantly higher than those in the non-recurrence group,but there was no significant difference between the recurrence and non-recurrence groups with multiple paraesophageal collateral veins.3.After endoscopic treatment,the number of cases with moderate and severe paraesophageal collaterals,periesophageal collaterals,and esophageal submucosal veins in the recurrence group was significantly higher than that in the non-recurrence group.4.The presence of perforating branches was more easily detected in the recurrence group.5.The F2-grade veins in the non-recurrence group were more significant than those in the recurrence group,but there was no significant difference in the F3-grade veins.6.endoscopic ultrasonography has a certain predictive value for Esophageal varices recurrence after endoscopic radical resection.