Surgical management of hiatal hernia vs medical therapy to treat bleeding Cameron lesions: a systematic review and meta-
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and Other Interventional Techniques
2020 SAGES ORAL
Surgical management of hiatal hernia vs medical therapy to treat bleeding Cameron lesions: a systematic review and meta‑analysis Kevin Verhoeff1 · Jerry T. Dang2 · Andy Deprato3 · Janice Y. Kung4 · Noah J. Switzer1 · Daniel W. Birch5 · Clarence Wong6 · Shahzeer Karmali5 Received: 5 July 2020 / Accepted: 27 October 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Introduction Cameron lesions (CL) are an under-recognized cause of gastrointestinal bleeding. Diagnosis is often impaired by technical difficulty, and once diagnosed, management remains unclear. Typically, patients are medically managed with proton pump inhibitors (PPI). Small studies have demonstrated improved therapeutic success with surgical management, hypothesizing that reversing mechanical gastric trauma and ischemia allows CL healing. This systematic review and meta-analysis aim to compare therapeutic success of surgical versus medical management of Cameron lesions (CL). Methods and procedures A comprehensive search and systematic review selected manuscripts using the following inclusion criteria: (1) Endoscopically diagnosed CL (2) Treated surgically (3) Follow-up for resolution of anemia or CL
(4) n ≥ 5 (5) Excluding non-English, animal, and studies with patients 5 cm.
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00464-020-08135-w) contains supplementary material, which is available to authorized users. * Jerry T. Dang [email protected] 1
Department of Surgery, University of Alberta, Edmonton, AB, Canada
2
Division of General Surgery, Department of Surgery, University of Alberta, University of Alberta Hospital, 8440 112 Street NW, Edmonton, AB T6G 2B7, Canada
3
University of Alberta, Edmonton, AB, Canada
4
John W. Scott Health Sciences Library, University of Alberta, Edmonton, AB, Canada
5
Centre for Advancement of Surgical Education and Simulation (CASES), Royal Alexandra Hospital, Edmonton, AB, Canada
6
Division of Gastroenterology, University of Alberta, Edmonton, AB, Canada
13
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Surgical Endoscopy
Surgical management was associated with therapeutic success (OR 5.20, 1.83–14.77, I2 = 42%, p
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