scholarly journals Meta-analysis of the impact of postoperative complications on survival after oesophagectomy for cancer

BJS Open ◽  
2018 ◽  
Vol 2 (5) ◽  
pp. 276-284 ◽  
Author(s):  
E. Booka ◽  
H. Takeuchi ◽  
K. Suda ◽  
K. Fukuda ◽  
R. Nakamura ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Meta Analysis ◽  
The Impact

scholarly journals Exploring the Relationship between Biologics and Postoperative Surgical Morbidity in Ulcerative Colitis: A Review

2021 ◽  
Vol 10 (4) ◽  
pp. 710
Author(s):  
Abel Botelho Quaresma ◽  
Fernanda da Silva Barbosa Baraúna ◽  
Fábio Vieira Teixeira ◽  
Rogério Saad-Hossne ◽  
Paulo Gustavo Kotze
Keyword(s):  
Ulcerative Colitis ◽  
Postoperative Complications ◽  
Meta Analysis ◽  
Qualitative Evaluation ◽  
Complication Rates ◽  
Surgical Morbidity ◽  
Randomized Studies ◽  
Pubmed Database ◽  
Increased Risk ◽  
The Impact

Background: With the paradigm shift related to the overspread use of biological agents in the treatment of inflammatory bowel diseases (IBD), several questions emerged from the surgical perspective. Whether the use of biologicals would be associated with higher rates of postoperative complications in ulcerative colitis (UC) patients still remains controversial. Aims: We aimed to analyze the literature, searching for studies that correlated postoperative complications and preoperative exposure to biologics in UC patients, and synthesize these data qualitatively in order to check the possible impact of biologics on postoperative surgical morbidity in this population. Methods: Included studies were identified by electronic search in the PUBMED database according to the PRISMA (Preferred Items of Reports for Systematic Reviews and Meta-Analysis) guidelines. The quality and bias assessments were performed by MINORS (methodological index for non-randomized studies) criteria for non-randomized studies. Results: 608 studies were initially identified, 22 of which were selected for qualitative evaluation. From those, 19 studies (17 retrospective and two prospective) included preoperative anti-TNF. Seven described an increased risk of postoperative complications, and 12 showed no significant increase postoperative morbidity. Only three studies included surgical UC patients with previous use of vedolizumab, two retrospective and one prospective, all with no significant correlation between the drug and an increase in postoperative complication rates. Conclusions: Despite conflicting results, most studies have not shown increased complication rates after abdominal surgical procedures in patients with UC with preoperative exposure to biologics. Further prospective studies are needed to better establish the impact of preoperative biologics and surgical complications in UC.

scholarly journals Geriatric nutritional risk index as a predictor of complications and long-term outcomes in patients with gastrointestinal malignancy: a systematic review and meta-analysis

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Hailun Xie ◽  
Shuangyi Tang ◽  
Lishuang Wei ◽  
Jialiang Gan
Keyword(s):  
Postoperative Complications ◽  
Meta Analysis ◽  
Risk Index ◽  
Nutritional Risk ◽  
Long Term Outcomes ◽  
Gastrointestinal Malignancy ◽  
Free Survival ◽  
Nutritional Risk Index ◽  
The Impact

Abstract Background The effect of the geriatric nutritional risk index (GNRI) on the prognosis of patients with gastrointestinal malignancy remains unclear. The aim of our study was to systematically explore the value of the GNRI in evaluating postoperative complications and long-term outcomes in gastrointestinal malignancy. Methods A systematic literature search was conducted using electronic databases to report the impact of the GNRI on postoperative complications and long-term outcomes of patients with gastrointestinal malignancies as of August 2020. The hazard ratio (HR) with a 95% confidence interval (CI) was used to evaluate the impact of the GNRI on long-term outcomes. The risk ratio (RR) with 95% CI was used to assess the impact of the GNRI on postoperative complications. Result A total of nine studies with 2,153 patients were enrolled in our meta-analysis. The results suggested that a low GNRI was correlated with poor overall survival of patients with gastrointestinal malignancy (HR = 1.94, 95% CI 1.65–2.28, p < 0.001). Patients with a low GNRI had a higher risk of complications than patients with a high GNRI (OR = 2.19, 95% CI 1.57–3.05, p < 0.001). In addition, patients with a low GNRI had shorter relapse-free survival (HR = 2.45, 95% CI 1.50–4.00, p < 0.001) and disease-free survival (HR = 1.84, 95% CI 1.23–2.76, p = 0.003) than those with a high GNRI. However, the GNRI was not an independent factor affecting cancer-specific survival (HR = 1.60, 95% CI 0.91–2.82, p = 0.101). Conclusion Based on existing evidence, the GNRI was a valuable predictor of complications and long-term outcomes in patients with gastrointestinal malignancy.

scholarly journals Impact of Smoking on the Incidence and Postoperative Complications of Total Knee Arthroplasty: A Systematic Review and Meta-Analysis of Cohort Studies

2021 ◽  
Author(s):  
Yuqi He ◽  
Mohamed Omar ◽  
Xiaoyuan Feng ◽  
Claudia Neunaber ◽  
Michael Jagodzinski
Keyword(s):  
Systematic Review ◽  
Total Knee Arthroplasty ◽  
Postoperative Complications ◽  
Cohort Studies ◽  
Knee Arthroplasty ◽  
Surgical Complications ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Total Knee ◽  
The Impact

Osteoarthritis and rheumatoid arthritis are the most ubiquitous joint disorders which cause tremendous loss of life quality and impose an economic burden on society. At present, the treatment options for these two diseases comprise non-operative and surgical treatments, amongst those total knee arthroplasties (TKA). Various studies have recognized smoking as a significant risk factor for postoperative complications. Therefore, the purpose of this study was to examine the impact of smoking on the incidence and postoperative complications after a total knee arthroplasty by a systematic review and meta-analysis. The research was performed using PUBMED, Cochrane Library and EMBASE, extracting data from thirteen suitable studies and incorporating 2,109,482 patients. Cohort studies evaluating the impact of smoking on TKA with sufficient data were included for the study, and cohort studies without a proper control group and complete data were excluded. A fixed-effects or random-effects model was used to measure the pooled risk ratio (RR) or hazard ratio (HR) with 95% confidence interval (CI). Compared to non-smokers, smokers had a significantly lower incidence of TKA (p<0.01). However, smokers had a higher incidence of total complications (p=0.01), surgical complications (p<0.01), pneumonia (p<0.01) and revision surgery (p=0.01). No significant difference in the risk of blood transfusion (p=0.42), deep vein thrombosis (p=0.31), pulmonary embolism (p=0.34), urinary tract infection (p=0.46) or mortality (p=0.39) was found between smokers and non-smokers. In conclusion, the study indicated that tobacco has two diametrically opposite effects on TKA patients: 1. Tobacco increases the incidence of surgical complications, pneumonia and revision after TKA; 2. It decreases the overall risk of being a candidate for TKA.

The impact of preoperative sarcopenia on postoperative complications following esophagectomy for esophageal neoplasia: a systematic review and meta-analysis

2020 ◽  
Vol 33 (7) ◽  
Author(s):  
Dimitrios Papaconstantinou ◽  
Konstantina Vretakakou ◽  
Anna Paspala ◽  
Evangelos P Misiakos ◽  
Anestis Charalampopoulos ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Meta Analysis ◽  
Performance Status ◽  
Random Effect ◽  
Random Effect Model ◽  
Cumulative Risk ◽  
Lumbar Vertebra ◽  
Skeletal Muscle Index ◽  
Significant Difference ◽  
The Impact

Summary Esophageal cancer is characterized by profound changes in body composition due to dysphagia and generalized cachexia. Sarcopenia or muscle wasting is a component of cachexia associated with poor postoperative performance status. The skeletal muscle index (SMI) calculated by computed tomography scans at the level of the third lumbar vertebra is an easily quantifiable and reproducible measure of sarcopenia. The aim of this meta-analysis is to investigate the impact of preoperative sarcopenia (low SMI) on postoperative complications after esophagectomy for neoplastic lesions. In this context, a comprehensive literature search was undertaken to identify studies reporting short-term postoperative outcomes in relation to their preoperative SMI values. Cumulative risk ratios (RR) and risk differences (RD) and their respective 95% confidence intervals (CIs) were calculated using a random-effect model. A total of 11 studies incorporating 1,979 total patients (964 patients with sarcopeniaversus 1,015 without sarcopenia) were included in the final analysis. The results demonstrated a significant increase in overall morbidity (RR 1.16, 95% CI 1.01–1.33), respiratory complications (RR 1.64, 95% CI 1.21–2.22) and anastomotic leaks (RR 1.39, 95% CI 1.10–1.76) in patients with sarcopenia. No statistically significant difference was noted in overall mortality (RD 0, 95% CI −0.02–0.02) or Clavien–Dindo grade III or greater complications (RR 1.17, 95% CI 0.96–1.42). The above results demonstrate the validity of the SMI as a predictive factor for post-esophagectomy complications. Although the risk associated with sarcopenia is not prohibitive for surgery, patients with low SMI require closer vigilance during their postoperative course due to the increased propensity for respiratory and anastomotic complications.

scholarly journals Evaluation of the Nighttime Operation Impact on Liver Transplantation: A Meta-Analysis

2021 ◽  
Vol 8 (4) ◽  
Author(s):  
Ziteng Zhang ◽  
◽  
Xiaoliang Zha ◽  
Xian He ◽  
Mingbo Wang ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Liver Transplant ◽  
Publication Bias ◽  
Organ Procurement ◽  
Meta Analysis ◽  
Current Evidence ◽  
Pubmed Database ◽  
Study Results ◽  
Significant Difference ◽  
The Impact

Background: Liver transplant is frequently performed at night due to the unpredictability of organ procurement and reduction of Cold Ischemia Time (CIT). Previous study reported a doubled mortality Hazard Ratio (HR) of early death and increased postoperative complications in nighttime liver transplant. This study aims to evaluate the impact of nighttime operation on patients’ survival and postoperative complications by using meta-analysis. Methods: We performed a systematic review of the PubMed database and identified five eligible studies. Three time points (30 days, 90 days and 1 year) were explored in patients’ survival by using pooled HR. Four types of postoperative complications (vascular, biliary tract, wound and primary graft non-function) were investigated by using pooled Odds Ratio (OR). Publication bias was also performed. Results: Our study results were contradicting with the previous report and yielded no significant difference with a HR=0.98 (95% CI=0.89-1.06) on 30 days, HR=1.12 (95% CI=0.89-1.35) on 90 days and HR=1.07 (95% CI=0.95-1.18) on 1 year in nighttime procedure. Consistent with the result of patients’ survival, no significant result was found in postoperative complications evaluation as well. None of the four complications demonstrated significant result. And we failed to detect any significant publication bias. Conclusions: Based on current evidence, nighttime liver transplantations do not degrade patients’ survival or increase postoperative complications risk compared with daytime operations.

scholarly journals Clinical Efficacy of Perioperative Immunonutrition Containing Omega-3-Fatty Acids in Patients Undergoing Hepatectomy: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

2020 ◽  
pp. 1-12
Author(s):  
Benjian Gao ◽  
Jia Luo ◽  
Ying Liu ◽  
Furui Zhong ◽  
Xiaoli Yang ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Hospital Stay ◽  
Randomized Controlled Trials ◽  
Fixed Effects ◽  
Meta Analysis ◽  
Length Of Hospital Stay ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
The Impact

<b><i>Background:</i></b> The effect of immunonutrition in patients undergoing hepatectomy remains unclear. This meta-analysis aimed to assess the impact of immunonutrition on postoperative clinical outcomes in patients undergoing hepatectomy. <b><i>Methods:</i></b> A literature search of PubMed, Cochrane Library, Web of Science, and Embase databases was performed to identify all randomized controlled trials (RCTs) exploring the effect of perioperative immunonutrition in patients undergoing hepatectomy until the end of March 10, 2020. Quality assessment and data extraction of RCTs were conducted independently by 3 reviewers. Mean difference (MD) and odds ratio (OR) with 95% confidence interval (CI) were calculated using a fixed-effects or random-effects model. The meta-analysis was performed with RevMan 5.3 software. <b><i>Results:</i></b> Nine RCTs involving a total of 966 patients were finally included. This meta-analysis showed that immunonutrition significantly reduced the incidences of overall postoperative complications (OR = 0.57, 95% CI: 0.34–0.95; <i>p</i> = 0.03), overall postoperative infectious complications (OR = 0.53, 95% CI: 0.37–0.75; <i>p</i> = 0.0003), and incision infection (OR = 0.50, 95% CI: 0.28–0.89; <i>p</i> = 0.02), and it shortened the length of hospital stay (MD = −3.80, 95% CI: −6.59 to −1.02; <i>p</i> = 0.007). There were no significant differences in the incidences of pulmonary infection (OR = 0.60, 95% CI: 0.32–1.12; <i>p</i> = 0.11), urinary tract infection (OR = 1.30, 95% CI: 0.55–3.08; <i>p</i> = 0.55), liver failure (OR = 0.54, 95% CI: 0.23–1.24; <i>p</i> = 0.15), and postoperative mortality (OR = 0.69, 95% CI: 0.26–1.83; <i>p</i> = 0.46). <b><i>Conclusion:</i></b> Given its positive impact on postoperative complications and the tendency to shorten the length of hospital stay, perioperative immunonutrition should be encouraged in patients undergoing hepatectomy.

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