Evidence map›Paper›PMID 20229072›Full record

SynthesisJournal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract2010

Effect of preoperative single-dose corticosteroid administration on postoperative morbidity following esophagectomy.

Edgard Engelman, Cécile Maeyens

Abstract readComparative StudyMeta-AnalysisReview
PubMed Publisher
In one paragraph

Synthesis in Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
22citing papers in PubMed, 4 pooled it
3.9field-weighted citation impact, top 7% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

22 citing papers in PubMed, 4 syntheses or guidelines pooled it, 52 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Use of pre-operative steroids in liver resection: a systematic review and meta-analysis.HPB : the official journal of the International Hepato Pancreato Biliary Association · 2014
    Pooled it
  4. Guideline
  5. Intraoperative corticosteroid administration for resectable gastric cancer: a multicenter, randomized, open-label, phase II/III study.Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association · 2025
    Trial
  6. Article
  7. Review
  8. Review
  9. Article
  10. Administration of Corticosteroids, Ascorbic Acid, and Thiamine Improves Oxygenation after Thoracoscopic Esophagectomy.Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia · 2020
    Article
  11. Advances in the surgical treatment of esophageal cancer since 1965.Annals of gastroenterological surgery · 2020
    Review
  12. Article
  13. Article
  14. Article
  15. Article
  16. Article
  17. Review
  18. Article
  19. Article
  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

2 authors at 1 institution in 1 country.

Edgard EngelmanDepartment of Anesthesiology, Post-anesthesia Care Unit and Acute Pain Service, Erasme Hospital, Route de Lennik 808, 1070 Brussels, Belgium. eengelma@ulb.ac.be
Cécile Maeyens
Erasmus Hospital · BE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundEight clinical trials involving the administration of preoperative i.v. methylprednisolone have been undertaken in order to decrease the considerable inflammatory response to esophageal resection, in an effort to decrease the supposedly associated morbidity and mortality

methodA meta-analysis was performed for eight clinical end-points. Due to quality problems in seven of the eight included studies, a Bayesian meta-analysis using a skeptical prior derived from the results of the classical analysis was also performed.

resultsThe end-points including any organ dysfunction (OR = 0.30), respiratory complication (OR = 0.41), sepsis (OR = 0.37), liver dysfunction (OR = 18), cardiovascular dysfunction (OR = 0.28), and surgical anastomotic leak (OR = 0.42) were significantly decreased by methylprednisolone pretreatment. Following the Bayesian analysis, despite the use of skeptical priors, there is a 95% probability to obtain a relative risk reduction of at least 23% to 54%, depending of the end-point, by methylprednisolone pretreatment.

conclusionWe are in the presence of a potential benefit that cannot be accepted at face value due to the quality problems of the included studies. But in the presence of a remaining potential benefit after a Bayesian analysis starting from a skeptical prior, the best option would be the planning of a large multicenter prospective randomized study.

Indexed as

Preoperative CareAdrenal Cortex HormonesDose-Response Relationship, DrugEsophageal NeoplasmsEsophagectomyFemaleFollow-Up StudiesHumansMaleMethylprednisoloneNeoplasm InvasivenessNeoplasm StagingPostoperative ComplicationsRandomized Controlled Trials as TopicRisk AssessmentSurvival AnalysisAdrenal Cortex HormonesMethylprednisolone

Identifiers

PMID20229072
OpenAlexW2052710450

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.