CRITICAL APPRAISAL OF SURGICAL THESES ON PORTAL HYPERTENSION. | ||
| The Egyptian Journal of Surgery | ||
| Article 3, Volume 20, Issue 4, October 2001, Pages 716-721 PDF (146.26 K) | ||
| Document Type: Original Article | ||
| DOI: 10.21608/ejsur.2001.375849 | ||
| Author | ||
| Nabil Dowidar* | ||
| Department of Clinical and Experimental Surgery, Medical Research Institute, University of Alexandria, Egypt | ||
| Abstract | ||
| Background: There are few local guidelines on the management of patients with oesophageal varices secondary to schistosomal hepatic fibrosis. The study aims at exploring this issue through a critical appraisal of the methodology used in surgical theses on portal hypertension. Material and methods: All surgical theses on portal hypertension, written over a 27-year period were analyzed through established criteria for evaluating research on portal hypertension. Results: Study design analysis revealed that 90% theses were case series reports and 10% were randomized clinical trials. Control of bleeding and patient survival were primary research end points in 30% and 25% of the theses, respectively. None of the theses had the number of patients required for their study statistically calculated beforehand. Patient population was defined in 30% of the theses and was heterogeneous in 50% of the theses; mixing bleeders with non-bleeders. Child-Pugh grading was followed in 15% of the theses. Endoscopic variceal grading was performed in 55% of the theses and in 10% were endoscopic risk signs for bleeding reported. Conclusion: This study has demonstrated the need for well-designed clinical trials on portal hypertension that have end points of primary importance, such as patient survival and control of bleeding. | ||
| Keywords | ||
| Hypertension; portal – esophageal and gastric varices - hematemesis – methods – clinical trials | ||
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