Short-term outcomes of laparoscopic surgery for colorectal cancer in the elderly versus non-elderly: a systematic review and meta-analysis

Objectives: The aim of this study was to assess the cost-effectiveness of laparoscopic surgery compared with open surgery for the treatment of colorectal cancer.Methods: A Markov model was developed to model cost-effectiveness over 25 years. Data on the clinical effectiveness of laparoscopic and open surgery for colorectal cancer were obtained from a systematic review of the literature. Data on costs came from a systematic review of economic evaluations and from published sources. The outcomes of the model were presented as the incremental cost per life-year gained and using cost-effectiveness acceptability curves to illustrate the likelihood that a treatment was cost-effective at various threshold values for society's willingness to pay for an additional life-year.Results: Laparoscopic surgery was on average £300 more costly and slightly less effective than open surgery and had a 30 percent chance of being cost-effective if society is willing to pay £30,000 for a life-year. One interpretation of the available data suggests equal survival and disease-free survival. Making this assumption, laparoscopic surgery had a greater chance of being considered cost-effective. Presenting the results as incremental cost per quality-adjusted life-year (QALY) made no difference to the results, as utility data were poor. Evidence suggests short-term benefits after laparoscopic repair. This benefit would have to be at least 0.01 of a QALY for laparoscopic surgery to be considered cost-effective.Conclusions: Laparoscopic surgery is likely to be associated with short-term quality of life benefits, similar long-term outcomes, and an additional £300 per patient. A judgment is required as to whether the short-term benefits are worth this extra cost.

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Impact of short-term exposure to extreme temperatures on diabetes mellitus morbidity and mortality? A systematic review and meta-analysis

10.21203/rs.3.rs-320376/v1 ◽

2021 ◽

Author(s):

Xuping Song ◽

Liangzhen Jiang ◽

Dongdong Zhang ◽

Xinyi Wang ◽

Yan Ma ◽

...

Keyword(s):

Diabetes Mellitus ◽

Systematic Review ◽

Meta Analysis ◽

Heat Exposure ◽

The Elderly ◽

Morbidity And Mortality ◽

Cochrane Library ◽

Extreme Temperatures ◽

Short Term ◽

Short Term Exposure

Abstract The relationship between diabetes mellitus and short-term exposure to extreme temperatures remains controversial. A systematic review and meta-analysis were performed to assess the association between extreme temperatures and diabetes mellitus morbidity and mortality. PubMed, Embase, the Cochrane Library, Web of Science and the Cumulative Index to Nursing and Allied Health Literature (CINAHL) were searched since inception to January 1, 2019, and updated on November 17, 2020. The results were combined using random effects model and reported as relative risk (RR) with 95% confidence interval (CI). 32 studies met the included criteria. (1) Both heat and cold exposures have impact on diabetes. (2) For heat exposure, the subgroup analysis revealed that the effect on diabetes mortality (RR = 1.139, 95% CI: 1.089–1.192) was higher than morbidity (RR = 1.012, 95% CI: 1.004–1.019). (3) With the increase of definition threshold, the impact of heat exposure on diabetes rised. (4) A stronger association between heat exposure and diabetes was observed in the elderly (≥ 60 years old) (RR = 1.040, 95% CI: 1.017–1.064). In conclusion, both short-term exposure to heat and cold temperatures have impact on diabetes. The elderly is the vulnerable population of diabetes exposure to heat temperature. Developing definitions of heatwaves at the regional level are suggested.

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Short-term outcomes of robotic-assisted right colectomy compared with laparoscopic surgery: A systematic review and meta-analysis

Asian Journal of Surgery ◽

10.1016/j.asjsur.2018.11.002 ◽

2019 ◽

Vol 42 (5) ◽

pp. 589-598 ◽

Cited By ~ 11

Author(s):

Shixun Ma ◽

Yan Chen ◽

Yifeng Chen ◽

Tiankang Guo ◽

Xiongfei Yang ◽

...

Keyword(s):

Systematic Review ◽

Laparoscopic Surgery ◽

Meta Analysis ◽

Right Colectomy ◽

Short Term ◽

Robotic Assisted

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Ambient temperature and cardiovascular mortality: a systematic review and meta-analysis

PeerJ ◽

10.7717/peerj.3574 ◽

2017 ◽

Vol 5 ◽

pp. e3574 ◽

Cited By ~ 35

Author(s):

Mohammad Taghi Moghadamnia ◽

Ali Ardalan ◽

Alireza Mesdaghinia ◽

Abbas Keshtkar ◽

Kazem Naddafi ◽

...

Keyword(s):

Systematic Review ◽

Cold Exposure ◽

Cardiovascular Mortality ◽

Meta Analysis ◽

Heat Exposure ◽

The Elderly ◽

Response Relationship ◽

Dose Response Relationship ◽

Short Term ◽

Relationship Of

Introduction Our study aims at identifying and quantifying the relationship between the cold and heat exposure and the risk of cardiovascular mortality through a systematic review and meta-analysis. Material and Methods A systematic review and meta-analysis were conducted based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline. Peer-reviewed studies about the temperature and cardiovascular mortality were retrieved in the MEDLINE, Web of Science, and Scopus databases from January 2000 up to the end of 2015. The pooled effect sizes of short-term effect were calculated for the heat exposure and cold exposure separately. Also, we assessed the dose–response relationship of temperature-cardiovascular mortality by a change in units of latitudes, longitude, lag days and annual mean temperature by meta-regression. Result After screening the titles, abstracts and full texts, a total of 26 articles were included in the meta-analysis. The risk of cardiovascular mortality increased by 5% (RR, 1.055; 95% CI [1.050–1.060]) for the cold exposure and 1.3% (RR, 1.013; 95% CI [1.011–1.015]) for the heat exposure. The short-term effects of cold and heat exposure on the risk of cardiovascular mortality in males were 3.8% (RR, 1.038; 95% CI [1.034–1.043]) and 1.1%( RR, 1.011; 95% CI [1.009–1.013]) respectively. Moreover, the effects of cold and heat exposure on risk of cardiovascular mortality in females were 4.1% (RR, 1.041; 95% CI [1.037–1.045]) and 1.4% (RR, 1.014; 95% CI [1.011–1.017]) respectively. In the elderly, it was at an 8.1% increase and a 6% increase in the heat and cold exposure, respectively. The greatest risk of cardiovascular mortality in cold temperature was in the 14 lag days (RR, 1.09; 95% CI [1.07–1.010]) and in hot temperatures in the seven lag days (RR, 1.14; 95% CI [1.09–1.17]). The significant dose–response relationship of latitude and longitude in cold exposure with cardiovascular mortality was found. The results showed that the risk of cardiovascular mortality increased with each degree increased significantly in latitude and longitude in cold exposure (0.2%, 95% CI [0.006–0.035]) and (0.07%, 95% CI [0.0003–0.014]) respectively. The risk of cardiovascular mortality increased with each degree increase in latitude in heat exposure (0.07%, 95% CI [0.0008–0.124]). Conclusion Our findings indicate that the increase and decrease in ambient temperature had a relationship with the cardiovascular mortality. To prevent the temperature- related mortality, persons with cardiovascular disease and the elderly should be targeted. The review has been registered with PROSPERO (registration number CRD42016037673).

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