Scolaris Content Display Scolaris Content Display

Reference flow chart
Figures and Tables -
Figure 1

Reference flow chart

Methodological quality graph: review authors' judgements about each methodological quality item presented as percentages across all included studies.
Figures and Tables -
Figure 2

Methodological quality graph: review authors' judgements about each methodological quality item presented as percentages across all included studies.

Methodological quality summary: review authors' judgements about each methodological quality item for each included study.
Figures and Tables -
Figure 3

Methodological quality summary: review authors' judgements about each methodological quality item for each included study.

Comparison 1 Intervention versus control, Outcome 1 Mortality.
Figures and Tables -
Analysis 1.1

Comparison 1 Intervention versus control, Outcome 1 Mortality.

Study

Aprotinin versus control

Lentschener 1999

In this trial, survival was reported for patients undergoing liver resection for colorectal liver metastases. The exact number of patients in each group was not stated and survival outcomes could not be included for meta‐analysis. The one‐year survival in patients with colorectal liver metastases was statistically greater in the aprotinin group than the control group. However, the survival advantage was lost at 28 months.

Figures and Tables -
Analysis 1.2

Comparison 1 Intervention versus control, Outcome 2 Survival.

Study

Antithrombin

Control

P value

Antithrombin III versus control

Shimada 1994

1/13 (7.7%)

1/11 (9.1%)

P > 0.9999

Figures and Tables -
Analysis 1.3

Comparison 1 Intervention versus control, Outcome 3 Liver failure.

Comparison 1 Intervention versus control, Outcome 5 Number requiring allogeneic blood transfusion.
Figures and Tables -
Analysis 1.5

Comparison 1 Intervention versus control, Outcome 5 Number requiring allogeneic blood transfusion.

Comparison 1 Intervention versus control, Outcome 6 Red cell transfusion.
Figures and Tables -
Analysis 1.6

Comparison 1 Intervention versus control, Outcome 6 Red cell transfusion.

Comparison 1 Intervention versus control, Outcome 7 Operating time (minutes).
Figures and Tables -
Analysis 1.7

Comparison 1 Intervention versus control, Outcome 7 Operating time (minutes).

Study

Tranexamic acid Mean (standard deviation)

ControlMean (standard deviation)

P value

Tranexamic acid versus control

Wu 2006

8 (7.66)

9 (7.66)

0.34

Figures and Tables -
Analysis 1.8

Comparison 1 Intervention versus control, Outcome 8 Hospital stay (days).

Comparison 1 Intervention versus control, Outcome 9 Transection blood loss (ml).
Figures and Tables -
Analysis 1.9

Comparison 1 Intervention versus control, Outcome 9 Transection blood loss (ml).

Comparison 1 Intervention versus control, Outcome 10 Operative blood loss (ml).
Figures and Tables -
Analysis 1.10

Comparison 1 Intervention versus control, Outcome 10 Operative blood loss (ml).

Study

Antithrombin III

Mean (standard deviation)

Control

Mean (standard deviation)

Mean difference

(95% confidence intervals)

Statistical signficance

Antithrombin III versus control

Shimada 1994

2.1(1.1)

2.5(1.3)

‐0.40 (‐1.37 to 0.57)

P = 0.42

Figures and Tables -
Analysis 1.11

Comparison 1 Intervention versus control, Outcome 11 Bilirubin (micromol/litre).

Study

Aprotinin

Mean (standard deviation)

Control

Mean (standard deviation)

Mean difference(95% confidence intervals)

Statistical significance

Aprotinin versus control

Lentschener 1999

63(12)

63(15)

0 (‐5.4 to 5.4)

P = 1.00

Figures and Tables -
Analysis 1.12

Comparison 1 Intervention versus control, Outcome 12 Prothrombin activity (percentage of normal activity).

Study

Antithrombin III

Mean (standard deviation)

Control

Mean (standard deviation)

Mean difference

(95% confidence intervals)

Statistical significance

Antithrombin III versus control

Shimada 1994

170 (86.5)

177(63)

‐7.00 (‐66.98 to 52.98)

P = 0.82

Figures and Tables -
Analysis 1.13

Comparison 1 Intervention versus control, Outcome 13 Aspartate transaminase (international units per litre) (peak).

Study

Antithrombin III

Mean (standard deviation)

Control

Mean (standard deviation)

Mean difference

(95% confidence intervals)

Statistical significance

Antithrombin III versus control

Shimada 1994

95 (39.7)

86 (39.8)

9.00 (‐22.92 to 40.92)

P = 0.58

Figures and Tables -
Analysis 1.14

Comparison 1 Intervention versus control, Outcome 14 Alanine transminase (international units per litre) (peak).

Comparison 2 Peri‐operative morbidity, Outcome 1 Tranexamic acid versus control.
Figures and Tables -
Analysis 2.1

Comparison 2 Peri‐operative morbidity, Outcome 1 Tranexamic acid versus control.

Comparison 2 Peri‐operative morbidity, Outcome 2 Recombinant VIIa (rFVIIa) high dose (80 to 100 mcg/kg) versus control.
Figures and Tables -
Analysis 2.2

Comparison 2 Peri‐operative morbidity, Outcome 2 Recombinant VIIa (rFVIIa) high dose (80 to 100 mcg/kg) versus control.

Comparison 2 Peri‐operative morbidity, Outcome 3 Recombinant VIIa (rFVIIa) low dose (20 to 50 mcg/kg) versus control.
Figures and Tables -
Analysis 2.3

Comparison 2 Peri‐operative morbidity, Outcome 3 Recombinant VIIa (rFVIIa) low dose (20 to 50 mcg/kg) versus control.

Comparison 2 Peri‐operative morbidity, Outcome 4 Recombinant VIIa (rFVIIa) high dose (80 to 100 mcg/kg) versus low dose (20 to 50 mcg/kg).
Figures and Tables -
Analysis 2.4

Comparison 2 Peri‐operative morbidity, Outcome 4 Recombinant VIIa (rFVIIa) high dose (80 to 100 mcg/kg) versus low dose (20 to 50 mcg/kg).

Study

Antithrombin

Control

P value

Infected intra‐abdominal collection

Shimada 1994

1/13 (7.7%)

1/11 (9.1%)

P > 0.9999

Figures and Tables -
Analysis 2.5

Comparison 2 Peri‐operative morbidity, Outcome 5 Anitithrombin III versus control.

Comparison 1. Intervention versus control

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Mortality Show forest plot

4

Risk Ratio (M‐H, Fixed, 95% CI)

Subtotals only

1.1 Aprotinin versus control

1

37

Risk Ratio (M‐H, Fixed, 95% CI)

1.18 [0.18, 7.48]

1.2 Tranexamic acid versus control

1

217

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

1.3 Recombinant VIIa (rFVIIa) high dose (80 to 100 mcg/kg) versus control

2

272

Risk Ratio (M‐H, Fixed, 95% CI)

0.79 [0.18, 3.51]

1.4 Recombinant VIIa (rFVIIa) low dose (20 to 50 mcg/kg) versus control

2

273

Risk Ratio (M‐H, Fixed, 95% CI)

1.59 [0.43, 5.89]

1.5 Recombinant VIIa (rFVIIa) high dose (80 to 100 mcg/kg) versus low dose (20 to 50 mcg/kg)

2

267

Risk Ratio (M‐H, Fixed, 95% CI)

0.46 [0.10, 2.08]

2 Survival Show forest plot

Other data

No numeric data

2.1 Aprotinin versus control

Other data

No numeric data

3 Liver failure Show forest plot

Other data

No numeric data

3.1 Antithrombin III versus control

Other data

No numeric data

4 Peri‐operative morbidity

Other data

No numeric data

4.1 See analysis 2

Other data

No numeric data

5 Number requiring allogeneic blood transfusion Show forest plot

5

Risk Ratio (M‐H, Fixed, 95% CI)

Subtotals only

5.1 Aprotinin versus control

1

97

Risk Ratio (M‐H, Fixed, 95% CI)

0.43 [0.21, 0.89]

5.2 Tranexamic acid versus control

1

214

Risk Ratio (M‐H, Fixed, 95% CI)

0.03 [0.00, 0.46]

5.3 Desmopressin versus control

1

59

Risk Ratio (M‐H, Fixed, 95% CI)

0.58 [0.15, 2.21]

5.4 Recombinant VIIa (rFVIIa) high dose (80 to 100 mcg/kg) versus control

2

272

Risk Ratio (M‐H, Fixed, 95% CI)

0.86 [0.62, 1.20]

5.5 Recombinant VIIa (rFVIIa) low dose (20 to 50 mcg/kg) versus control

2

273

Risk Ratio (M‐H, Fixed, 95% CI)

1.24 [0.94, 1.64]

5.6 Recombinant VIIa (rFVIIa) high dose (80 to 100 mcg/kg) versus low dose (20 to 50 mcg/kg)

2

267

Risk Ratio (M‐H, Fixed, 95% CI)

0.69 [0.51, 0.94]

6 Red cell transfusion Show forest plot

4

Std. Mean Difference (IV, Fixed, 95% CI)

Subtotals only

6.1 Desmopressin versus control

1

59

Std. Mean Difference (IV, Fixed, 95% CI)

‐0.31 [‐0.82, 0.21]

6.2 Recombinant VIIa (rFVIIa) high dose (80 to 100 mcg/kg) versus control

2

272

Std. Mean Difference (IV, Fixed, 95% CI)

0.01 [‐0.23, 0.24]

6.3 Recombinant VIIa (rFVIIa) high dose (20 to 50 mcg/kg) versus control

2

269

Std. Mean Difference (IV, Fixed, 95% CI)

0.19 [‐0.05, 0.43]

6.4 Recombinant VIIa (rFVIIa) high dose (80 to 100 mcg/kg) versus low dose (20 to 50 mcg/kg)

2

267

Std. Mean Difference (IV, Fixed, 95% CI)

‐0.19 [‐0.43, 0.05]

6.5 Antithrombin versus control

1

24

Std. Mean Difference (IV, Fixed, 95% CI)

0.07 [‐0.73, 0.88]

7 Operating time (minutes) Show forest plot

6

Mean Difference (IV, Fixed, 95% CI)

Subtotals only

7.1 Aprotinin versus control

1

97

Mean Difference (IV, Fixed, 95% CI)

‐1.0 [‐30.08, 28.08]

7.2 Tranexamic acid versus control

1

214

Mean Difference (IV, Fixed, 95% CI)

‐52.20 [‐86.15, ‐18.25]

7.3 Desmopressin versus control

1

59

Mean Difference (IV, Fixed, 95% CI)

‐30.0 [‐112.69, 52.69]

7.4 Recombinant VIIa (rFVIIa) high dose (80 to 100 mcg/kg) versus control

2

272

Mean Difference (IV, Fixed, 95% CI)

‐16.80 [‐40.42, 6.81]

7.5 Recombinant VIIa (rFVIIa) high dose (20 to 50 mcg/kg) versus control

2

269

Mean Difference (IV, Fixed, 95% CI)

7.38 [‐18.41, 33.16]

7.6 Recombinant VIIa (rFVIIa) high dose (80 to 100 mcg/kg) versus low dose (20 to 50 mcg/kg)

2

267

Mean Difference (IV, Fixed, 95% CI)

‐24.29 [‐48.84, 0.27]

7.7 Antithrombin versus control

1

24

Mean Difference (IV, Fixed, 95% CI)

‐28.0 [‐79.80, 23.80]

8 Hospital stay (days) Show forest plot

Other data

No numeric data

8.1 Tranexamic acid versus control

Other data

No numeric data

9 Transection blood loss (ml) Show forest plot

2

Mean Difference (IV, Fixed, 95% CI)

Subtotals only

9.1 Tranexamic acid versus control

1

214

Mean Difference (IV, Fixed, 95% CI)

‐260.0 [‐434.99, ‐85.01]

9.2 Desmopressin versus control

1

59

Mean Difference (IV, Fixed, 95% CI)

‐45.0 [‐626.86, 536.86]

10 Operative blood loss (ml) Show forest plot

6

Mean Difference (IV, Fixed, 95% CI)

Subtotals only

10.1 Aprotinin versus control

1

97

Mean Difference (IV, Fixed, 95% CI)

‐434.00 [‐873.67, 1.67]

10.2 Tranexamic acid versus control

1

214

Mean Difference (IV, Fixed, 95% CI)

‐300.0 [‐502.05, ‐97.95]

10.3 Desmopressin versus control

1

59

Mean Difference (IV, Fixed, 95% CI)

32.5 [‐695.69, 760.69]

10.4 Recombinant VIIa (rFVIIa) high dose (80 to 100 mcg/kg) versus control

2

272

Mean Difference (IV, Fixed, 95% CI)

‐156.86 [‐427.71, 113.99]

10.5 Recombinant VIIa (rFVIIa) low dose (20 to 50 mcg/kg) versus control

2

273

Mean Difference (IV, Fixed, 95% CI)

138.29 [‐166.99, 443.57]

10.6 Recombinant VIIa (rFVIIa) high dose (80 to 100 mcg/kg) versus low dose (20 to 50 mcg/kg)

2

267

Mean Difference (IV, Fixed, 95% CI)

‐299.54 [‐577.54, ‐21.54]

10.7 Antithrombin versus control

1

24

Mean Difference (IV, Fixed, 95% CI)

463.00 [‐326.67, 1252.67]

11 Bilirubin (micromol/litre) Show forest plot

Other data

No numeric data

11.1 Antithrombin III versus control

Other data

No numeric data

12 Prothrombin activity (percentage of normal activity) Show forest plot

Other data

No numeric data

12.1 Aprotinin versus control

Other data

No numeric data

13 Aspartate transaminase (international units per litre) (peak) Show forest plot

Other data

No numeric data

13.1 Antithrombin III versus control

Other data

No numeric data

14 Alanine transminase (international units per litre) (peak) Show forest plot

Other data

No numeric data

14.2 Antithrombin III versus control

Other data

No numeric data

Figures and Tables -
Comparison 1. Intervention versus control
Comparison 2. Peri‐operative morbidity

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Tranexamic acid versus control Show forest plot

1

Risk Ratio (M‐H, Fixed, 95% CI)

Subtotals only

1.1 Ascites

1

214

Risk Ratio (M‐H, Fixed, 95% CI)

0.98 [0.29, 3.29]

1.2 Intra‐abdominal abscess

1

214

Risk Ratio (M‐H, Fixed, 95% CI)

0.74 [0.26, 2.05]

1.3 Bile leak

1

214

Risk Ratio (M‐H, Fixed, 95% CI)

1.96 [0.37, 10.49]

1.4 Wound infection

1

214

Risk Ratio (M‐H, Fixed, 95% CI)

0.65 [0.11, 3.84]

1.5 Pleural effusion

1

214

Risk Ratio (M‐H, Fixed, 95% CI)

0.49 [0.05, 5.33]

2 Recombinant VIIa (rFVIIa) high dose (80 to 100 mcg/kg) versus control Show forest plot

2

Risk Ratio (M‐H, Fixed, 95% CI)

Subtotals only

2.1 Bile leak

1

150

Risk Ratio (M‐H, Fixed, 95% CI)

0.34 [0.01, 8.27]

2.2 Hyperamylasemia

1

150

Risk Ratio (M‐H, Fixed, 95% CI)

3.08 [0.13, 74.42]

2.3 Pleural effusion

1

150

Risk Ratio (M‐H, Fixed, 95% CI)

3.08 [0.13, 74.42]

2.4 Myocardial infarction

2

272

Risk Ratio (M‐H, Fixed, 95% CI)

3.08 [0.13, 74.42]

2.5 Pulmonary embolism

2

272

Risk Ratio (M‐H, Fixed, 95% CI)

1.05 [0.15, 7.28]

2.6 Deep vein thrombosis

1

122

Risk Ratio (M‐H, Fixed, 95% CI)

1.07 [0.16, 7.34]

2.7 Portal vein thrombosis

2

272

Risk Ratio (M‐H, Fixed, 95% CI)

0.36 [0.01, 8.56]

2.8 Mesenteric vein thrombosis

1

150

Risk Ratio (M‐H, Fixed, 95% CI)

3.08 [0.13, 74.42]

3 Recombinant VIIa (rFVIIa) low dose (20 to 50 mcg/kg) versus control Show forest plot

2

Risk Ratio (M‐H, Fixed, 95% CI)

Subtotals only

3.1 Bile leak

1

147

Risk Ratio (M‐H, Fixed, 95% CI)

1.07 [0.07, 16.79]

3.2 Hyperamylasemia

1

147

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

3.3 Pleural effusion

1

147

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

3.4 Myocardial infarction

2

273

Risk Ratio (M‐H, Fixed, 95% CI)

5.0 [0.24, 102.10]

3.5 Pulmonary embolism

2

273

Risk Ratio (M‐H, Fixed, 95% CI)

1.03 [0.14, 7.38]

3.6 Deep vein thrombosis

1

126

Risk Ratio (M‐H, Fixed, 95% CI)

0.2 [0.01, 4.08]

3.7 Portal vein thrombosis

2

273

Risk Ratio (M‐H, Fixed, 95% CI)

1.03 [0.15, 7.14]

3.8 Mesenteric vein thrombosis

1

147

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

4 Recombinant VIIa (rFVIIa) high dose (80 to 100 mcg/kg) versus low dose (20 to 50 mcg/kg) Show forest plot

2

Risk Ratio (M‐H, Fixed, 95% CI)

Subtotals only

4.1 Bile leak

1

145

Risk Ratio (M‐H, Fixed, 95% CI)

0.32 [0.01, 7.73]

4.2 Hyperamylasemia

1

145

Risk Ratio (M‐H, Fixed, 95% CI)

2.88 [0.12, 69.55]

4.3 Pleural effusion

1

145

Risk Ratio (M‐H, Fixed, 95% CI)

2.88 [0.12, 69.55]

4.4 Myocardial infarction

2

267

Risk Ratio (M‐H, Fixed, 95% CI)

0.68 [0.11, 4.12]

4.5 Pulmonary embolism

2

267

Risk Ratio (M‐H, Fixed, 95% CI)

1.07 [0.07, 16.69]

4.6 Deep vein thrombosis

1

122

Risk Ratio (M‐H, Fixed, 95% CI)

5.33 [0.26, 108.84]

4.7 Portal vein thrombosis

2

267

Risk Ratio (M‐H, Fixed, 95% CI)

0.32 [0.01, 7.73]

4.8 Mesenteric vein thrombosis

1

145

Risk Ratio (M‐H, Fixed, 95% CI)

2.88 [0.12, 69.55]

5 Anitithrombin III versus control Show forest plot

Other data

No numeric data

5.1 Infected intra‐abdominal collection

Other data

No numeric data

Figures and Tables -
Comparison 2. Peri‐operative morbidity