Laparoscopic Sleeve-Fundoplication for Morbidly Obese Patients with Gastroesophageal Reflux: Systematic Review and Meta-analysis

Abstract Introduction Laparoscopic sleeve gastrectomy (LSG) has rapidly become popular with excellent results. However, LSG may exacerbate or increase the risk of “de novo” gastroesophageal reflux disease (GERD). Adding a fundoplication has been proposed to increase the lower esophageal sphincter competency. The aim of this study was to examine the current evidence and outcomes of sleeve-fundoplication (Sleeve-F). Materials and Methods Systematic review and meta-analysis. Web of Science, PubMed, and Embase data sets were consulted. Results Six studies (485 patients) met the inclusion criteria. The age of the patient population ranged from 17 to 72 years old and 82% were females. All patients underwent sleeve-fundoplication. Rossetti, Collis-Nissen, and Nissen were the most commonly performed fundoplications. The estimated pooled prevalence of postoperative leak, gastric perforation, and overall complications were 1.0% (95% CI = 0.0–2.0%), 2.9% (95% CI = 0.0–8.3%), and 9.8% (95% CI = 6.7–13.4%), respectively. The pooled reoperation rate was 4.1% (95% CI = 1.3–10%). There was no mortality. At 12-month follow-up, the estimated pooled BMI and %EWL were 29.9 kg/m2 (95% CI = 28.5–31.2) and 66.2% (95% CI = 59.3–71.1), respectively, while esophagitis, PPI consumption, and GERD rates were 8.0% (95% CI 3–21%), 7.8% (95% CI 5–13%), and 11% (95% CI 4–26%). Conclusions This systematic review and meta-analysis shows that current evidence for Sleeve-F is limited with high postoperative gastric perforation and overall complication rates. Weight loss and GERD resolution seem promising in the short term; however, further studies are warranted to explore long-term effects with instrumental investigations. Sleeve-F should be considered cautiously while future well-structured randomized trials are warranted.

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Safety and Postoperative Outcomes of Regional versus Global Ischemia for Partial Nephrectomy: A Systematic Review and Meta-Analysis

Urologia Internationalis ◽

10.1159/000367997 ◽

2014 ◽

Vol 94 (4) ◽

pp. 428-435 ◽

Cited By ~ 1

Author(s):

Yiduo Wang ◽

Huan Qu ◽

Lei Zhang ◽

Shuqiu Chen ◽

Bin Xu ◽

...

Keyword(s):

Systematic Review ◽

Partial Nephrectomy ◽

Weighted Mean Difference ◽

Meta Analysis ◽

Global Ischemia ◽

Current Evidence ◽

Complication Rates ◽

Regional Ischemia ◽

Estimated Blood Loss ◽

Ischemia Group

Objective: To analyze current evidence comparing the safety and outcomes of regional and global ischemia for partial nephrectomy (PN). Materials and Methods: A systematic search of the PubMed and Web of Science databases was conducted in May 2014 to identify studies comparing the safety and outcomes of regional and global ischemia for PN. A systematic review and meta-analysis was also performed. Results: Six retrospective observational studies were selected for the analysis, including 363 patients who underwent PN (162 regional ischemia and 201 global ischemia cases). Operation times were not statistically different [weighted mean difference (WMD) = 20.35 min, 95% CI: -0.28-40.97, p = 0.05], but estimated blood loss was significantly higher in the regional ischemia group (WMD = 52.04 ml, 95% CI: 14.30-89.78, p = 0.007) than in the global ischemia group. Complication rates [odds ratio (OR) = 1.16; 95% CI: 0.63-2.15, p = 0.63] and blood transfusion rates (OR = 1.85; 95% CI: 0.86-4.01, p = 0.12) of the two groups were not significantly different. The regional ischemia group showed better postoperative renal function (WMD = 4.23 ml/min, 95% CI: 2.61-5.85, p < 0.00001) than the global ischemia group, and all cases in the regional ischemia group showed negative margins. Conclusions: Regional ischemia is as safe to perform as global ischemia, and the former leads to better postoperative renal functions than the latter. These findings support the application of regional ischemia for PN.

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Injection therapy for base of thumb osteoarthritis: a systematic review and meta-analysis

BMJ Open ◽

10.1136/bmjopen-2018-027507 ◽

2019 ◽

Vol 9 (9) ◽

pp. e027507 ◽

Cited By ~ 3

Author(s):

Nicholas Riley ◽

Martinique Vella-Baldacchino ◽

Neal Thurley ◽

Sally Hopewell ◽

Andrew J Carr ◽

...

Keyword(s):

Systematic Review ◽

Hyaluronic Acid ◽

Meta Analysis ◽

Outcome Data ◽

Injection Therapy ◽

Current Evidence ◽

Visual Analogue Scale Pain ◽

Long Term Effects ◽

Medium Term ◽

Short Term

ObjectiveTo evaluate the effectiveness of injection-based therapy in base of thumb osteoarthritis.DesignSystematic review and meta-analysis.Data sourcesMEDLINE and EMBASE via OVID, CINAHL and SPORTDiscus via EBSCO were searched from inception to 22 May 2018.Study selectionRandomised controlled trials (RCTs) and non-RCTs of adults with base of thumb osteoarthritis investigating an injection-based intervention with any comparator/s.Data extraction and analysisData were extracted and checked for accuracy and completeness by pairs of reviewers. Primary outcomes were pain and function. Comparative treatment effects were analysed by random-effects model for short-term and medium-term follow-up.ResultsIn total, 9 RCTs involving 504 patients were identified for inclusion. All compared different injection-based therapies with each other, no studies compared an injection-based therapy with a non-injection-based intervention. Twenty injection-based intervention groups were present within these nine trials, consisting of hyaluronic acid (n=9), corticosteroid (n=7), saline placebo (n=3) and dextrose (n=1). Limited meta-analysis was possible due to the heterogeneity in the injections and outcomes used, as well as incomplete outcome data. Meta-analysis of two RCTs (92 patients) demonstrated reduced Visual Analogue Scale pain on activity with corticosteroid versus hyaluronic acid (mean difference (MD) −1.32, 95% CI −2.23 to −0.41) in the medium term, but no differences in other measures of pain or function in the short term and medium term. Overall, the available evidence does not suggest that any of the commonly used injection therapies are superior to placebo, one another or a non-injection-based comparator.ConclusionCurrent evidence is equivocal regarding the use of injection therapy in base of thumb osteoarthritis, both in terms of which injection-based therapy is the most effective and in terms of whether any injection-based therapy is more effective than other non-injection-based interventions. Given limited understanding of both the short-term and long-term effects, there is a need for a large, methodologically robust RCT investigating the commonly used injection therapies and comparing them with other therapeutic options and placebo.PROSPERO registration numberCRD42018095384.

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Comparison of Different Operative Approaches for Lumbar Disc Herniation: A Network Meta- Analysis and Systematic Review

January 2018 - Pain Physician ◽

10.36076/ppj.2021.24.e381 ◽

2021 ◽

pp. E381-E392

Keyword(s):

Systematic Review ◽

Lumbar Disc Herniation ◽

Disc Herniation ◽

Lumbar Disc ◽

Meta Analysis ◽

Reoperation Rate ◽

Cochrane Library ◽

Surgical Approaches ◽

Complication Rates ◽

Dural Tear

BACKGROUND: New approaches and technologies can be beneficial for patients but also bring corresponding complications. Traditional pairwise meta-analyses cannot be used to comprehensively rank all surgical approaches. OBJECTIVES: The purpose of this systematic review and network meta-analysis (NMA) was to compare the outcomes of different surgical approaches for lumbar disc herniation (LDH). STUDY DESIGN: NMA of randomized controlled trials (RCTs) for multiple treatment comparisons of LDH. METHODS: The PubMed, Embase, MEDLINE, Ovid, and Cochrane Library databases were searched for RCTs comparing different surgical approaches for patients with LDH from inception to February 10, 2020. The Markov chain Monte Carlo methods were used to perform a hierarchical Bayesian NMA in WinBUGS version 1.4.3 using a random effects consistency model. The primary outcomes were disability and pain intensity. The secondary outcomes were complications and reoperation. The PROSPERO number was CRD42020179406. RESULTS: A total of 22 trials including 2529 patients and all 5 different approaches (open discectomy or microdiscectomy [OD/MD], microendoscopic discectomy [MED], percutaneous endoscopic discectomy [PED], percutaneous discectomy [PD], and tubular discectomy [TD]) were retrospectively retrieved. PED had the best efficacy in improving patients’ dysfunction with no statistical significance (probability = 50%). PD was significantly worse than OD/MD, MED, and PED in relieving patients’ pain (standardized mean differences: 0.87 [0.03, 1.76], 0.94 [0.06, 1.88], and 1.02 [0.13, 1.94], respectively). There was no statistically significant difference between any 2 surgical approaches in dural tear; intraoperative, postoperative, and overall complications; or reoperation rate. PED had the lowest dural tear rate and the lowest intraoperative and overall complication rates (probability = 51%, 67%, and 33%, respectively). TD had the lowest postoperative complication and reoperation rates (probability = 35% and 39%, respectively). LIMITATIONS: The limitations of this NMA include the inconsistent follow-up times, the criteria for complications, and the reasons for reoperation. CONCLUSIONS: Compared with other approaches used to treat LDH, PED had the best safety and efficacy in general, and TD had the lowest reoperation rate. Finally, we recommended PED for LDH. KEY WORDS: Lumbar disc herniation, network meta-analysis, minimally invasive surgery, surgical approaches, efficacy, safety

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Acceptability of mobile-phone reminders for routine childhood vaccination appointments in Nigeria – a systematic review and meta-analysis

BMC Health Services Research ◽

10.1186/s12913-021-07296-1 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Paul Eze ◽

Sergius Alex Agu ◽

Ujunwa Justina Agu ◽

Yubraj Acharya

Keyword(s):

Systematic Review ◽

Mobile Phone ◽

Meta Analysis ◽

Childhood Vaccination ◽

Routine Immunization ◽

Current Evidence ◽

Long Term Effects ◽

Childhood Immunization ◽

Routine Childhood ◽

To Receive

Abstract Background Mobile-phone reminders have gained traction among policymakers as a way to improve childhood vaccination coverage and timeliness. However, there is limited evidence on the acceptability of mobile-phone reminders among patients and caregivers. This systematic review and meta-analysis aimed to evaluate the ownership of mobile-phone device and the willingness to receive mobile-phone reminders among mothers/caregivers utilizing routine childhood immunization services in Nigeria. Method MEDLINE, Scopus, CINAHL, CNKI, AJOL (African Journal Online), and Web of Science were systematically searched for studies on the acceptability of mobile-phone reminders for routine immunization appointments among mothers/caregivers in Nigeria. Studies were assessed for methodological quality using the Newcastle Ottawa Scale and JBI critical appraisal checklists. Meta-analysis was conducted using random-effects model to generate pooled estimates (proportion) of mothers who owned at least one mobile phone and proportion of mothers willing to receive mobile-phone reminders. Results Sixteen studies (13 cross-sectional and three interventional) involving a total of 9923 mothers across 15 states and the Federal Capital Territory Abuja met inclusion criteria. Pooled estimates showed that the proportion of mothers who owned at least one mobile phone was 96.4% (95% CI = 94.1–98.2%; I2 = 96.3%) while the proportion of mothers willing to receive mobile-phone reminders was 86.0% (95% CI = 79.8–91.3%, I2 = 98.4%). Most mothers preferred to receive text message reminders at least 24 h before the routine immunization appointment day, and in the morning hours. Approximately 52.8% of the mothers preferred to receive reminders in English, the country’s official language. Conclusion Current evidence suggests a high acceptability for mobile-phone reminder interventions to improve routine childhood immunization coverage and timeliness. Further studies, however, are needed to better understand unique regional preferences and assess the operational costs, long-term effects, and risks of this intervention. Systematic review protocol registration PROSPERO CRD42021234183.

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Liquid Biopsy for Small Cell Lung Cancer either De Novo or Transformed: Systematic Review of Different Applications and Meta-Analysis

Cancers ◽

10.3390/cancers13092265 ◽

2021 ◽

Vol 13 (9) ◽

pp. 2265

Author(s):

Elio Gregory Pizzutilo ◽

Martino Pedrani ◽

Alessio Amatu ◽

Lorenzo Ruggieri ◽

Calogero Lauricella ◽

...

Keyword(s):

Lung Cancer ◽

Systematic Review ◽

Small Cell Lung Cancer ◽

Cell Lung Cancer ◽

Liquid Biopsy ◽

De Novo ◽

Meta Analysis ◽

Small Cell ◽

Genomic Profiling ◽

Small Cell Lung

Background: The potential added value of liquid biopsy (LB) is not well determined in the case of small cell lung cancer (SCLC), an aggressive tumor that can occur either de novo or from the histologic transformation of non-small cell lung cancer (NSCLC). Methods: A systematic review of studies adopting LB in patients with SCLC have been performed to assess the clinical utility of circulating tumor DNA (ctDNA) or circulating tumor cells (CTCs). Results: After a screening of 728 records, 62 studies (32 evaluating CTCs, 27 ctDNA, and 3 both) met predetermined eligibility criteria. Only four studies evaluated LB in the diagnostic setting for SCLC, while its prognostic significance was evaluated in 38 studies and prominently supported by both ctDNA and CTCs. A meta-analysis of 11 studies as for CTCs enumeration showed an HR for overall survival of 2.63 (1.71–4.05), with a potential publication bias. The feasibility of tumor genomic profiling and the predictive role of LB in terms of response/resistance to chemotherapy was assessed in 11 and 24 studies, respectively, with greater consistency for those regarding ctDNA. Intriguingly, several case reports suggest that LB can indirectly capture the transition to SCLC in NSCLC treated with EGFR tyrosine kinase inhibitors. Conclusions: While dedicated trials are needed, LB holds potential clinical roles in both de novo and transformed SCLC. CtDNA analysis appears the most valuable and practicable tool for both disease monitoring and genomic profiling.

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The Prevalence of Sarcopenia and Its Impact on Clinical Outcomes in Lumbar Degenerative Spine Disease—A Systematic Review and Meta-Analysis

Journal of Clinical Medicine ◽

10.3390/jcm10040773 ◽

2021 ◽

Vol 10 (4) ◽

pp. 773

Author(s):

Wei-Ting Wu ◽

Tsung-Min Lee ◽

Der-Sheng Han ◽

Ke-Vin Chang

Keyword(s):

Quality Of Life ◽

Systematic Review ◽

Clinical Outcomes ◽

Meta Analysis ◽

Clinical Manifestations ◽

Current Evidence ◽

Degenerative Spine ◽

Degenerative Spine Disease ◽

Spine Disease

The association of sarcopenia with poor clinical outcomes has been identified in various medical conditions, although there is a lack of quantitative analysis to validate the influence of sarcopenia on patients with lumbar degenerative spine disease (LDSD) from the available literature. Therefore, this systematic review and meta-analysis aimed to summarize the prevalence of sarcopenia in patients with LDSD and examine its impact on clinical outcomes. The electronic databases (PubMed and Embase) were systematically searched from inception through December 2020 for clinical studies investigating the association of sarcopenia with clinical outcomes in patients with LDSD. A random-effects model meta-analysis was carried out for data synthesis. This meta-analysis included 14 studies, comprising 1953 participants. The overall prevalence of sarcopenia among patients with LDSD was 24.8% (95% confidence interval [CI], 17.3%–34.3%). The relative risk of sarcopenia was not significantly increased in patients with LDSD compared with controls (risk ratio, 1.605; 95% CI, 0.321–8.022). The patients with sarcopenia did not experience an increase in low back and leg pain. However, lower quality of life (SMD, −0.627; 95% CI, −0.844–−0.410) were identified postoperatively. Sarcopenia did not lead to an elevated rate of complications after lumbar surgeries. Sarcopenia accounts for approximately one-quarter of the population with LDSD. The clinical manifestations are less influenced by sarcopenia, whereas sarcopenia is associated with poorer quality of life after lumbar surgeries. The current evidence is still insufficient to support sarcopenia as a predictor of postoperative complications.

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Complications of Outpatient and Inpatient Renal Biopsy: A Systematic Review and Meta-Analysis

Diagnostics ◽

10.3390/diagnostics11040651 ◽

2021 ◽

Vol 11 (4) ◽

pp. 651

Author(s):

Shih-Yi Lin ◽

Cherry Yin-Yi Chang ◽

Cheng-Chieh Lin ◽

Wu-Huei Hsu ◽

I.-Wen Liu ◽

...

Keyword(s):

Systematic Review ◽

Renal Biopsy ◽

Meta Analysis ◽

Random Effect ◽

Bleeding Risk ◽

Complication Rates ◽

Bleeding Events ◽

Cochrane Database ◽

Renal Biopsies ◽

Inpatient Settings

Background: The evidence indicates that the optimal observation period following renal biopsy ranges between 6 and 8 h. This systematic review and meta-analysis explored whether differences exist in the complication rates of renal biopsies performed in outpatient and inpatient settings. Methods: We searched the MEDLINE, EMBASE, and the Cochrane Database of Systematic Reviews from 1985 to February 2020. Two reviewers independently selected studies evaluating the bleeding risk from renal biopsies performed in outpatient and inpatient settings and reviewed their full texts. The primary and secondary outcomes were risks of bleeding and major events (including mortality) following the procedure, respectively. Subgroup analysis was conducted according to the original study design (i.e., prospective or retrospective). Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using a random effect meta-analysis. Heterogeneity was assessed using the I2 test. Results: Data from all 10 eligible studies, which included a total of 1801 patients and 203 bleeding events, were included for analysis. Renal biopsies in outpatient settings were not associated with a higher bleeding risk than those in inpatient settings (OR = 0.81; 95% CI, 0.59–1.11; I2 = 0%). The risk of major events was also comparable across both groups (OR = 0.45; 95% CI, 0.16–1.29; I2 = 4%). Conclusions: Similar rates of bleeding and major events following renal biopsy in outpatient and inpatient settings were observed.

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More than 50 long-term effects of COVID-19: a systematic review and meta-analysis

Scientific Reports ◽

10.1038/s41598-021-95565-8 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Sandra Lopez-Leon ◽

Talia Wegman-Ostrosky ◽

Carol Perelman ◽

Rosalinda Sepulveda ◽

Paulina A. Rebolledo ◽

...

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Management Strategies ◽

Original Data ◽

Long Term Effects ◽

Pooled Prevalence ◽

Attention Disorder ◽

Initial Recovery ◽

Meta Analyses

AbstractCOVID-19 can involve persistence, sequelae, and other medical complications that last weeks to months after initial recovery. This systematic review and meta-analysis aims to identify studies assessing the long-term effects of COVID-19. LitCOVID and Embase were searched to identify articles with original data published before the 1st of January 2021, with a minimum of 100 patients. For effects reported in two or more studies, meta-analyses using a random-effects model were performed using the MetaXL software to estimate the pooled prevalence with 95% CI. PRISMA guidelines were followed. A total of 18,251 publications were identified, of which 15 met the inclusion criteria. The prevalence of 55 long-term effects was estimated, 21 meta-analyses were performed, and 47,910 patients were included (age 17–87 years). The included studies defined long-COVID as ranging from 14 to 110 days post-viral infection. It was estimated that 80% of the infected patients with SARS-CoV-2 developed one or more long-term symptoms. The five most common symptoms were fatigue (58%), headache (44%), attention disorder (27%), hair loss (25%), and dyspnea (24%). Multi-disciplinary teams are crucial to developing preventive measures, rehabilitation techniques, and clinical management strategies with whole-patient perspectives designed to address long COVID-19 care.

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Evaluation of the effectiveness of behavioural economic incentive programmes for the promotion of a healthy diet and physical activity: a protocol for a systematic review and network meta-analysis

BMJ Open ◽

10.1136/bmjopen-2020-046035 ◽

2020 ◽

Vol 10 (12) ◽

pp. e046035

Author(s):

Suparee Boonmanunt ◽

Oraluck Pattanaprateep ◽

Boonsong Ongphiphadhanakul ◽

Gareth McKay ◽

John Attia ◽

...

Keyword(s):

Physical Activity ◽

Systematic Review ◽

Financial Incentives ◽

Meta Analysis ◽

Economic Incentive ◽

Healthy Diet ◽

Current Evidence ◽

Diet And Physical Activity ◽

Behavioural Economic ◽

Meta Analyses

IntroductionObesity and being overweight are major risk factors for metabolic syndrome and non-communicable diseases. Despite the recommendation that a healthy diet and physical activity can reduce the severity of these diseases, many fail to adhere to these measures. From a behavioural economic perspective, adherence to such measures can be encouraged through financial incentives. However, additional related behavioural economic approaches may improve the effectiveness of an incentive programme. As such, we have developed a protocol for a systematic review and network meta-analysis to summarise the current evidence from financial incentive programmes with and without behavioural economic insights for promoting healthy diet and physical activity.Methods and analysisPrevious systematic reviews, meta-analyses and individual studies were identified from Medline and Scopus in June 2020 and will be updated until December 2020. Individual studies will be selected and data extracted by two reviewers. Disagreement will be resolved by consensus or adjudicated by a third reviewer. A descriptive analysis will summarise the effectiveness of behavioural economic incentive programmes for promoting healthy diet and physical activity. Moreover, individual studies will be pooled using network meta-analyses where possible. I2 statistics and Cochran’s Q test will be used to assess heterogeneity. Risk of bias and publication bias, if appropriate, will be evaluated, as well as the overall strength of the evidence.Ethics and disseminationEthics approval for a systematic review and meta-analysis is not required. The findings will be published in a peer-reviewed journal.PROSPERO registration numberCRD42020198024.

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Surgical treatment of recalcitrant gastroesophageal reflux disease in patients with systemic sclerosis: a systematic review

Langenbeck s Archives of Surgery ◽

10.1007/s00423-021-02118-8 ◽

2021 ◽

Author(s):

Alberto Aiolfi ◽

Mario Nosotti ◽

Kazuhide Matsushima ◽

Carolina Perali ◽

Cristina Ogliari ◽

...

Keyword(s):

Systematic Review ◽

Systemic Sclerosis ◽

Surgical Treatment ◽

Gastroesophageal Reflux Disease ◽

Gastroesophageal Reflux ◽

Reflux Disease ◽

Current Data ◽

Current Evidence ◽

Increased Risk

Abstract Introduction Gastroesophageal reflux disease (GERD) is frequently seen in patients with systemic sclerosis (SSc). Long-standing GERD may cause esophagitis, long-segment strictures, and Barrett’s esophagus and may worsen pre-existing pulmonary fibrosis with an increased risk of end-stage lung disease. Surgical treatment of recalcitrant GERD remains controversial. The purpose of this systematic review was to summarize the current data on surgical treatment of recalcitrant GERD in SSc patients. Materials and methods A systematic literature review according to PRISMA and MOOSE guidelines. PubMed, EMBASE, and Web of Science databases were consulted. Results A total of 101 patients were included from 7 studies. The age ranged from 34 to 61 years and the majority were females (73.5%). Commonly reported symptoms were heartburn (92%), regurgitation (77%), and dysphagia (74%). Concurrent pulmonary disease was diagnosed in 58% of patients. Overall, 63 patients (62.4%) underwent open fundoplication, 17 (16.8%) laparoscopic fundoplication, 15 (14.9%) Roux en-Y gastric bypass (RYGB), and 6 (5.9%) esophagectomy. The postoperative follow-up ranged from 12 to 65 months. Recurrent symptoms were described in up to 70% and 30% of patients undergoing fundoplication and RYGB, respectively. Various symptoms were reported postoperatively depending on the type of surgical procedures, anatomy of the valve, need for esophageal lengthening, and follow-up. Conclusions The treatment of recalcitrant GERD in SSc patients is challenging. Esophagectomy should be reserved to selected patients. Minimally invasive RYGB appears feasible and safe with promising preliminary short-term results. Current evidence is scarce while a definitive indication about the most appropriate surgical treatment is lacking.

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