Systematic review and meta-analysis of the role of somatostatin and its analogues in the treatment of enterocutaneous fistula.

Abstract

OBJECTIVE:

Somatostatin analogues may help pancreatic fistula although it remains unclear whether they help nonpancreatic fistula. This study involved meta-analysis of somatostatin analogues for treatment of enterocutaneous fistula.

METHODS:

Meta-analysis of studies was undertaken, to estimate the effect of somatostatin analogues on spontaneous closure, time to closure and mortality.

RESULTS:

Results showed significant associations between somatostatin and both spontaneous closure rate [odds ratio (OR) 6.61, 95% (CI) confidence interval 1.35-32.43] and time to closure (standardized mean difference -0.80, 95% CI: -1.34 to -0.26). Octreotide reduced closure time (standardized mean difference -0.57, 95% CI: -0.95 to -0.20) but not spontaneous closure (OR: 1.74, 95% CI: 0.64-4.76). Lanreotide also improved time to closure (mean of 17 days vs. 26 days, standard deviation not stated) but not spontaneous closure (OR: 0.94, 95% CI: 0.42-2.12). Somatostatin, octreotide and lanreotide did not significantly affect mortality (OR: 0.30, 0.82, and 0.48; 95% CI: 0.03-3.47, 0.38-1.78, and 0.04-5.07 respectively).

CONCLUSION:

Somatostatin and octreotide improved fistula closure time but only somatostatin improved spontaneous closure rate.

• Authors: Philip Stevens, Rhiannon E Foulkes, Jake S Hartford-Beynon, Raymond J Delicata
• Journal: European journal of gastroenterology & hepatology (Eur J Gastroenterol Hepatol) Vol. 23 Issue 10 Pg. 912-22 (Oct 2011) ISSN: 1473-5687 [Electronic] England
• PMID: 21814141 (Publication Type: Journal Article, Meta-Analysis, Review, Systematic Review)

Chemical References

• Gastrointestinal Agents
• Somatostatin
• Octreotide

Topics

• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Female
• Gastrointestinal Agents (therapeutic use)
• Humans
• Intestinal Fistula (drug therapy)
• Male
• Middle Aged
• Octreotide (therapeutic use)
• Somatostatin (analogs & derivatives, therapeutic use)
• Treatment Outcome
• Young Adult