ABSTRACT
Objective
Several randomized control trials (RCTs) have compared somatostatin and its analogs versus a control group in patients with enterocutaneous fistulas (ECF). This study meta-analyzes the literature and establishes whether it shows a beneficial effect on ECF closure.
MethodsWe searched MEDLINE, EMBASE, CINAHL, Cochrane, and PubMed databases according to PRISMA guidelines. Seventy-nine articles were screened. Nine RCTs met the inclusion criteria. Statistical analyses were performed using Review Manager 5.1.
ResultsSomatostatin analogs versus control Number of fistulas closed: A significant number of ECFs closed in the somatostatin analog group compared to control group; P = 0.002. Time to closure: ECFs closed significantly faster with somatostatin analogs compared to controls; P < 0.0001. Mortality: No significant difference between somatostatin analogs and controls; P = 0.68.
Somatostatin versus control Number of fistulas closed: A significant number of ECFs closed with somatostatin as compared to control; P = 0.04. Time to closure: ECFs closed significantly faster with somatostatin than controls; P < 0.00001. Mortality: No significant difference between somatostatin and controls; P = 0.63.
ConclusionsSomatostatin and octreotide increase the likelihood of fistula closure. Both are beneficial in reducing the time to fistula closure. Neither has an effect on mortality. The risk ratio (RR) for somatostatin was higher than the RR for analogs. This may suggest that somatostatin could be better than analogs in relation to the number of fistulas closed and time to closure. Further studies are required to corroborate these apparent findings.
