Abstract：
OBJECTIVE: To evaluate the efficacy of scheduled second-look endoscopy in patients with acute peptic ulcer bleeding (PUB).
METHODS: We systematically search in four databases for randomized controlled trials (RCTs) that evaluated the usefulness of scheduled second-look endoscopy vs. single endoscopy in patients with PUB. Our primary outcome was rebleeding. Secondary outcomes were surgery, mortality, and the number of units of blood transfused (NUBT). All meta-analyses were performed using a random-effects model. Pooled risk ratio (RR) and mean difference (MD), with their 95% confidence intervals (CIs) were calculated for categorical and continuous outcomes, respectively. The risk of bias was assessed using the Cochrane RoB 2.0 tool, and the quality of evidence (QoE) was rated with the GRADE approach.
RESULTS: Eight full-text RCTs and two RCT abstracts were included (n=1513). We did not find differences in rebleeding (RR, 0.78; 95% CI, 0.53-1.14, moderate QoE), surgery (RR, 0.58; 95% CI, 0.29-1.15, moderate QoE), mortality (RR, 0.89; 95% CI, 0.46-1.71, moderate QoE) or NUBT (MD, -0.01 units; 95% CI, -0.3 to 0.28, low QoE) between second-look and single endoscopy. Sensitivity analyses had similar results to the main analyses.
CONCLUSIONS: Routine second-look endoscopy was not more efficacious than single endoscopy in patients with PUB.
METHODS: We systematically search in four databases for randomized controlled trials (RCTs) that evaluated the usefulness of scheduled second-look endoscopy vs. single endoscopy in patients with PUB. Our primary outcome was rebleeding. Secondary outcomes were surgery, mortality, and the number of units of blood transfused (NUBT). All meta-analyses were performed using a random-effects model. Pooled risk ratio (RR) and mean difference (MD), with their 95% confidence intervals (CIs) were calculated for categorical and continuous outcomes, respectively. The risk of bias was assessed using the Cochrane RoB 2.0 tool, and the quality of evidence (QoE) was rated with the GRADE approach.
RESULTS: Eight full-text RCTs and two RCT abstracts were included (n=1513). We did not find differences in rebleeding (RR, 0.78; 95% CI, 0.53-1.14, moderate QoE), surgery (RR, 0.58; 95% CI, 0.29-1.15, moderate QoE), mortality (RR, 0.89; 95% CI, 0.46-1.71, moderate QoE) or NUBT (MD, -0.01 units; 95% CI, -0.3 to 0.28, low QoE) between second-look and single endoscopy. Sensitivity analyses had similar results to the main analyses.
CONCLUSIONS: Routine second-look endoscopy was not more efficacious than single endoscopy in patients with PUB.
摘要：
目的：评价对急性消化性溃疡出血（PUB）患者行二次内镜检查的疗效。
方法：我们在四个数据库中系统地搜索随机对照试验（RCT），这些试验评估了预定的二次内窥镜检查与PUB患者的单内镜检查。我们的主要结果是再出血。次要结果是手术，死亡率,以及输血单位数（NUBT）。所有荟萃分析均使用随机效应模型进行。集合风险比(RR)和平均差(MD)，用他们的95%置信区间(CI)计算分类和连续结果，分别。使用CochraneRoB2.0工具评估偏倚风险，并采用分级方法对证据质量(QoE)进行评级。
结果：共纳入8份全文RCT和2份RCT摘要（n=1513）。我们没有发现再出血的差异(RR，0.78；95%CI，0.53-1.14，中等QoE），手术（RR，0.58；95%CI，0.29-1.15，中等QoE），死亡率(RR，0.89；95%CI，0.46-1.71，中等QoE）或NUBT（MD，-0.01单位；95％CI，-0.3至0.28，低QoE）在第二次内窥镜检查和单次内窥镜检查之间。敏感性分析的结果与主要分析相似。
结论：在PUB患者中，常规的二次内窥镜检查并不比单次内窥镜检查更有效。
方法：我们在四个数据库中系统地搜索随机对照试验（RCT），这些试验评估了预定的二次内窥镜检查与PUB患者的单内镜检查。我们的主要结果是再出血。次要结果是手术，死亡率,以及输血单位数（NUBT）。所有荟萃分析均使用随机效应模型进行。集合风险比(RR)和平均差(MD)，用他们的95%置信区间(CI)计算分类和连续结果，分别。使用CochraneRoB2.0工具评估偏倚风险，并采用分级方法对证据质量(QoE)进行评级。
结果：共纳入8份全文RCT和2份RCT摘要（n=1513）。我们没有发现再出血的差异(RR，0.78；95%CI，0.53-1.14，中等QoE），手术（RR，0.58；95%CI，0.29-1.15，中等QoE），死亡率(RR，0.89；95%CI，0.46-1.71，中等QoE）或NUBT（MD，-0.01单位；95％CI，-0.3至0.28，低QoE）在第二次内窥镜检查和单次内窥镜检查之间。敏感性分析的结果与主要分析相似。
结论：在PUB患者中，常规的二次内窥镜检查并不比单次内窥镜检查更有效。
