Systematic review and network Meta-analysis of venoactive drug for the treatment of hemorrhoidectomy complications
Objective:To systematically evaluate the efficacy of different venoactive drugs in the treatment of hemorrhoidectomy complications.Methods:EMbase,PubMed,The Cochrane Library,CNKI,and WanFang database were searched systematically,and randomized controlled trials(RCTs)related to the efficacy of venoactive drugs in the treatment of hemorrhoidectomy complications were included up to December 2023.Meta-analysis and network Meta-analysis were performed using Stata 16.0 software after 2 researchers screened the literature according to inclusion and exclusion criteria,extracted data,and evaluated the methodological quality of the included studies.Results:A total of 22 articles(6 RCTs)were enrolled,including 2 743 patients.The results of the traditional Meta-analysis and network Meta-analysis showed that the venoactive drugs combined with the conventional treatment group could significantly reduce the incidence of postoperative complications,shorten the duration of complications,improve complication scores,and promote wound healing,with statistical significance(P＜0.05).Network Meta-analysis showed that MPFF was the most effective in improving postoperative bleeding score and shortening postoperative bleeding time.Diosmin has the best effect in reducing postoperative edema rate and bleeding rate.Aesculus was the best in shortening wound healing time and improving the total effective rate of postoperative complications.Coumarins have the best effect on shortening postoperative pain and edema time,reducing postoperative pain and edema score.Conclusion:Existing evidence suggests that venoactive drugs are effective in the treatment of hemorrhoidectomy complications,and each venoactive drug has distinct benefits in complications.However,due to the limitations of the number and quality of included studies,the above conclusions still need to be verified by more large-sample multi-center clinical trials.
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