Impact of frailty in benign gynecologic surgery: a systematic review

2021 ◽  
Author(s):  
Jacqueline Y. Kikuchi ◽  
Katerina Hoyt ◽  
Andrea I. Nomura ◽  
Sindhura Vallabhaneni ◽  
Jaime Blanck ◽  
...  
Keyword(s):  
Systematic Review ◽  
Gynecologic Surgery

scholarly journals Efficacy of pre-operative pharmacologic thromboprophylaxis on incidence of venous thromboembolism following major gynecologic and gynecologic oncology surgery: a systematic review and meta-analysis

2020 ◽  
pp. ijgc-2020-001991
Author(s):  
Steven Bisch ◽  
Rachelle Findley ◽  
Christina Ince ◽  
Maria Nardell ◽  
Gregg Nelson
Keyword(s):  
Systematic Review ◽  
Venous Thromboembolism ◽  
Methodological Quality ◽  
Meta Analysis ◽  
Gynecologic Oncology ◽  
Quality Data ◽  
Gynecologic Surgery ◽  
Cochrane Central Register ◽  
Pharmacologic Prophylaxis ◽  
Pharmacologic Thromboprophylaxis

IntroductionVenous thromboembolism remains a significant complication following major gynecologic surgery. Evidence is lacking on whether it is beneficial to give pharmacologic thromboprophylaxis pre-operatively. The aim of this meta-analysis was to assess the role of pre-operative pharmacologic thromboprophylaxis in preventing post-operative venous thromboembolism.MethodsPubMed, EMBASE, and the Cochrane Central Register of Clinical Trials were searched to find randomized controlled, cohort, and case–control trials comparing pre-operative pharmacologic thromboprophylaxis to no prophylaxis, mechanical prophylaxis, or only post-operative pharmacologic thromboprophylaxis for open and minimally invasive major gynecologic surgery (benign and malignant conditions). Two authors independently assessed abstracts, full-text articles, and methodological quality. Data were extracted and pooled using ORs for random effects meta-analysis. Heterogeneity was explored using forest plots, Q-statistic, and I2 statistics. Planned subgroup analysis of use of sequential compression devices, equivalent versus non-equivalent post-operative prophylaxis, cancer diagnosis, and methodological quality were performed.ResultsSome 503 unique studies were found, and 16 studies (28 806 patients) were included in the systematic review. Twelve studies (14 273 patients) were included in the meta-analysis. The OR for incidence of post-operative venous thromboembolism was 0.59 (95% CI 0.39, 0.89), favoring pre-operative pharmacologic thromboembolism prophylaxis compared with no pre-operative pharmacologic prophylaxis (Q=13.80, I2=20.30). In studies where post-operative care was equivalent between groups, the OR for venous thromboembolism was 0.56 (95% CI 0.22, 1.40). Pre-operative pharmacologic prophylaxis demonstrated greatest benefit when utilized with both intra-operative and post-operative sequential compression devices (OR 0.43, 95% CI 0.30, 0.64) compared with when no sequential compression devices were utilized (OR 1.27, 95% CI 0.63, 2.56). When looking at only studies determined to be of high quality, the results no longer reached significance (OR 0.73, 95% CI 0.36, 1.46).ConclusionsPre-operative pharmacologic thromboprophylaxis decreases the odds of venous thromboembolism in the peri-operative period for major gynecologic oncology surgery by approximately 40%. It remains unclear whether this benefit is present in benign and minor procedures. Adequately powered studies are needed.

The robotic single-port platform for gynecologic surgery: a systematic review of the literature and meta-analysis

2020 ◽  
Author(s):  
Vito Andrea Capozzi ◽  
Giulia Armano ◽  
Andrea Rosati ◽  
Alessandro Tropea ◽  
Antonio Biondi
Keyword(s):  
Systematic Review ◽  
Single Port ◽  
Meta Analysis ◽  
Gynecologic Surgery ◽  
Review Of The Literature

scholarly journals Cost assessment of robotics in gynecologic surgery: A systematic review

2014 ◽  
Vol 40 (11) ◽  
pp. 2125-2134 ◽  
Author(s):  
Christos Iavazzo ◽  
Eleni K. Papadopoulou ◽  
Ioannis D. Gkegkes
Keyword(s):  
Systematic Review ◽  
Gynecologic Surgery ◽  
Cost Assessment

Do prophylactic antibiotics in gynecologic surgery prevent postoperative inflammatory complications? A systematic review

2017 ◽  
Vol 295 (6) ◽  
pp. 1383-1391 ◽  
Author(s):  
Cedric Emanuel Boesch ◽  
Roderick Franziskus Pronk ◽  
Fabian Medved ◽  
Pascal Hentschel ◽  
Hans-Eberhard Schaller ◽  
...  
Keyword(s):  
Systematic Review ◽  
Prophylactic Antibiotics ◽  
Gynecologic Surgery ◽  
Postoperative Inflammatory Complications

scholarly journals Enhanced recovery pathways in abdominal gynecologic surgery: a systematic review and meta-analysis

2015 ◽  
Vol 95 (4) ◽  
pp. 382-395 ◽  
Author(s):  
Jeanny J.A. de Groot ◽  
Stephanie M.C. Ament ◽  
José M.C. Maessen ◽  
Cornelis H.C. Dejong ◽  
Jos M.P. Kleijnen ◽  
...  
Keyword(s):  
Systematic Review ◽  
Enhanced Recovery ◽  
Meta Analysis ◽  
Gynecologic Surgery ◽  
Enhanced Recovery Pathways ◽  
Recovery Pathways

Systematic review of neuropathic component in persistent post-surgical pain

2012 ◽  
Vol 3 (3) ◽  
pp. 184-184
Author(s):  
S. Haroutiunian ◽  
L. Nikolajsen ◽  
N.B. Finnerup ◽  
T.S. Jensen
Keyword(s):  
Systematic Review ◽  
Neuropathic Pain ◽  
Hernia Repair ◽  
Varicose Vein ◽  
Groin Hernia ◽  
Iliac Crest ◽  
Gynecologic Surgery ◽  
Groin Hernia Repair ◽  
Pain Mechanisms ◽  
Surgical Pain

Abstract Background/aim The aim of the current study was to assess the neuropathic component of persistent post-surgical pain (PPSP) following eleven types of surgery. Methods We performed a systematic PubMed, CENTRAL and EMBASE search to identify studies on PPSP following (i) thoracic surgery, (ii) breast surgery, (iii) groin hernia repair, (iv) prostatectomy, (v) major abdominal surgery, (vi) gynecologic surgery, (vii) iliac crest bone harvest, (viii) total hip arthroplasty (THA) or knee arthroplasty (TKA), (ix) varicose vein stripping or ablation, (x) mandibular sagittal split osteotomy and (xi) donor nephrectomy, and assessed the prevalence of Probable/Definite neuropathic pain using the recently published neuropathic pain probability grading criteria [1]. Results We included 291 relevant papers. Surgeries performed in the thoracic/breast area resulted in similarly high median PPSP prevalence of about 30–35%; bone and joint surgeries resulted in similar PPSP prevalence of about 20%; and surgeries on visceral organs resulted in lower PPSP prevalence of 10–14%. The reported ranges of PPSP prevalence were very wide, between 0 and 91%. The prevalence of Probable/Definite neuropathic pain among patients with PPSP was about 65% after thoracic and breast surgeries, about 32% after groin hernia repair and gynecologic surgery, and between 9 and 16% after bone and joint surgeries such as iliac crest bone harvest and THA/TKA. In varicose vein surgeries and mandibular sagittal split osteotomies more research is needed to investigate the contribution of neuropathic pain mechanisms. Conclusion PPSP after different surgeries is reported to be common and often neuropathic. This systematic review of the literature showed that reported PPSP prevalences range widely among studies, and only a minority of studies used methodology that enabled the estimation of Probable/Definite neuropathic pain prevalence.

Sign in / Sign up

Export Citation Format

Share Document