scholarly journals Closure Versus Non-closure of Hernia Defect in Laparoscopic Ventral Hernia Repair with Mesh: a Systematic Review

2021 ◽  
Author(s):  
Emad Aljohani
Keyword(s):  
Quality Of Life ◽  
Hernia Repair ◽  
Randomized Controlled Trials ◽  
Ventral Hernia ◽  
Observational Studies ◽  
Fascial Closure ◽  
Controlled Trials ◽  
Patient’S Satisfaction ◽  
Randomized Controlled

AbstractThere is a controversial premise about choosing a surgical approach in ventral hernia using laparoscopic repair. Some surgeons prefer to use mesh with closure while others prefer to use mesh without closure. This study aims to compare mainly the rate of recurrence in mesh repair with and without closure. A wide range of electronic bibliographic databases such as PubMed, Embase and Education Resources Information Center (ERIC) was searched. Based on the eligibility criteria, all studies which compared the results after hernia repair from 2010 to 2020 were incorporated. Following screening the abstracts, we ended up reviewing seven full-text articles, and data were extracted on important parameters such as demographic attributes of participants, sample size and recurrence rate of hernia. Of the total studies that were reviewed, three were randomized controlled trials (RCT’s) and four retrospective observational studies. The sample size of all included studies varied between 80 and 176. The findings appear promising for the fascial closure as it showed evidence of a significant reduction in the recurrence rate with P = 0.047 in one out of the three randomized controlled trials and in the retrospective observational studies reaching up to 16.7% recurrence reduction rate. Likewise, there is also a reduction in the bulging, surgical site infection and seroma formation with higher patient’s satisfaction and quality of life score. Primary fascial closure appears to be effective as it can decrease the rates of recurrence, seroma formation and bulging, and improve patient’s satisfaction and quality of life. Given the dearth of studies, mainly randomized controlled trials, there is a need to carry out large randomized controlled trials with enough follow-up.

scholarly journals Closure Versus Non-Closure of Hernia Defect in Laparoscopic Ventral Hernia Repair with Mesh: A Systematic Review

2021 ◽  
Author(s):  
Emad Aljohani
Keyword(s):  
Quality Of Life ◽  
Hernia Repair ◽  
Randomized Controlled Trials ◽  
Ventral Hernia ◽  
Observational Studies ◽  
Fascial Closure ◽  
Controlled Trials ◽  
Patient’S Satisfaction ◽  
Randomized Controlled

Abstract PurposeThere is a controversial premise about choosing a surgical approach in ventral hernia using laparoscopic repair. Some surgeons prefer to use mesh with closure while others prefer to use mesh without closure. This study aims to compare mainly the rate of recurrence in mesh repair with and without closure. MethodsA wide range of electronic bibliographic databases such as PubMed, Embase, and ERIC was searched. Based on the eligibility criteria, all studies which compared the results after hernia repair from 2010 to 2020, were incorporated. Following screening the abstracts, we ended up reviewing seven full-text articles, and data were extracted on important parameters such as demographic attributes of participants, sample size, and recurrence rate of hernia.ResultsOf the total studies that were reviewed, three were randomized controlled trials (RCT’s) and four retrospective observational studies. The sample size of all included studies varied between 80 to 176. The findings appear promising for the fascial closure as it showed an evidence of significant reduction in the recurrence rate with P = 0•047 in one out of the three RCT’s and in the retrospective observational studies reaching up to 16.7 % recurrence reduction rate. Likewise, there is also a reduction in the bulging, surgical site infection and seroma formation with higher patient’s satisfaction and quality of life score.ConclusionPrimary fascial closure appears to be effective as it can decrease the rates of recurrence, seroma formation, bulging and improve patient’s satisfaction and quality of life. Given the dearth of studies, mainly randomized controlled trials, there is a need to carry out large randomized controlled trials with enough follow-up.

scholarly journals EXPRESS: The benefit of exercise-based rehabilitation programmes in patients with pulmonary hypertension: a systematic review and meta-analysis of randomized controlled trials

2021 ◽  
pp. 204589402110078
Author(s):  
Lu Yan ◽  
Wence Shi ◽  
Zhi-hong Liu ◽  
Qin Luo ◽  
Zhihui Zhao ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Pulmonary Hypertension ◽  
Randomized Controlled Trials ◽  
Exercise Capacity ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
The Mean ◽  
Quality Evidence

Background: Several studies have suggested that exercise capacity and quality of life are reduced in patients with pulmonary hypertension (PH), and exercise-based rehabilitation can improve exercise capacity and quality of life in patients with PH. The aim of this study is to assess the efficacy and safety of exercise-based rehabilitation in patients with PH through a meta-analysis of randomized controlled trials. Methods: We searched PubMed, Embase, Medline, and the Cochrane Central Register of Controlled Trials up to November 2018. All randomized controlled trials (RCTs) comparing exercise capacity and quality of life between patients undergoing exercise-based rehabilitation and those undergoing non-exercise training were included. Data were extracted separately and independently by two investigators, and discrepancies were arbitrated by the third investigator. We used the random-effects model to analyze the results, the GRADE to assess the risk of bias in the included studies, and I ² statistic to estimate the degree of heterogeneity. Results: Nine RCTs are included, however, only seven RCTs were able to extract data. Including inpatients and outpatients, the total number of participants was 234, most of whom were diagnosed as pulmonary artery hypertension (PAH). The study duration ranged from 3 to15 weeks. The mean six-minute walk distance after exercise training was 51.94 metres higher than control (27.65 to 76.23 metres, n=234, 7 RCTs, low quality evidence), the mean peak oxygen uptake  was 2.96 ml/kg/minute higher (2.49 to 3.43 ml/kg/minute, n=179, 4 RCTs, low-quality evidence) than in the control group . Concluded: Our finding suggest that an exercise-based training program positively influences exercise capacity in patients with PH.

The effectiveness of functional electrical stimulation of the legs in patients with heart failure: A systematic review and meta-analysis of randomized controlled trials

2021 ◽  
pp. 026921552110569
Author(s):  
Hsun-Yi Wang ◽  
Yu-Hsuan Chen ◽  
Yi-Chun Kuan ◽  
Shih-Wei Huang ◽  
Li-Fong Lin ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Heart Failure ◽  
Electrical Stimulation ◽  
Confidence Interval ◽  
Randomized Controlled Trials ◽  
Functional Electrical Stimulation ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Patients With Heart Failure

Objective To investigate the effectiveness of functional electrical stimulation of the legs in patients with heart failure. Methods Data were obtained from PubMed, Cochrane Library, and Embase databases until August 12, 2021. We included randomized controlled trials that evaluated the effects of functional electrical stimulation applied to the legs of patients with heart failure, namely changes in cardiopulmonary function, muscle strength, and quality of life. Results In total, 14 randomized controlled trials (consisting of 518 patients) were included in our article. Pooled estimates demonstrated that functional electrical stimulation significantly improved peak oxygen consumption (peak VO2; standardized mean difference = 0.33, 95% confidence interval = 0.07–0.59, eight randomized controlled trials, n = 321), 6-min walking distance (mean difference = 48.03 m, 95% confidence interval = 28.50–67.57 m, 10 randomized controlled trials, n = 380), and Minnesota Living with Heart Failure Questionnaire quality of life score (mean difference =  − 8.23, 95% confidence interval =  − 12.64 to − 3.83, nine randomized controlled trials, n = 383). Muscle strength of lower extremities was not significantly improved in the functional electrical stimulation group compared with that in the control group (standardized mean difference = 0.26, 95% confidence interval =  − 0.18 to 0.71, five randomized controlled trials, n = 218). Furthermore, the subgroup analysis revealed that functional electrical stimulation significantly improved peak VO2, 6-min walking distance, and Minnesota Living with Heart Failure Questionnaire quality of life score in the heart failure with reduced ejection fraction and heart failure with preserved ejection fraction subgroups. Conclusion Functional electrical stimulation can effectively improve the cardiopulmonary function and quality of life in patients with heart failure. However, functional electrical stimulation did not significantly improve muscle strength in the legs.

scholarly journals Exercise and Quality of Life in Women with Menopausal Symptoms: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

2020 ◽  
Vol 17 (19) ◽  
pp. 7049
Author(s):  
Thi Mai Nguyen ◽  
Thi Thanh Toan Do ◽  
Tho Nhi Tran ◽  
Jin Hee Kim
Keyword(s):  
Quality Of Life ◽  
Randomized Controlled Trials ◽  
Risk Of Bias ◽  
Menopausal Symptoms ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Study Objective ◽  
Positive Effects ◽  
Randomized Controlled

Menopausal symptoms are associated with deterioration in physical, mental, and sexual health, lowering women’s quality of life (QoL). Our study objective is to examine the effect of exercise on QoL in women with menopausal symptoms. After initially identifying 1306 studies published on PubMed, Web of Science, Scopus, and Cochrane Library before June 2020, two researchers independently selected nine randomized controlled trials (RCTs) in which any type of exercise was compared with no active treatment. We assessed the risk of bias in the included studies using the Cochrane risk-of-bias 2.0 tool for RCTs and computed the converged standardized mean difference with a 95% confidence interval. We found evidences for the positive effects of exercise on physical and psychological QoL scores in women with menopausal symptoms. However, there was no evidence for the effects of exercise on general, social, and menopause-specific QoL scores. The most common interventions for women with menopausal and urinary symptoms were yoga and pelvic floor muscle training (PFMT), respectively. In our meta-analyses, while yoga significantly improved physical QoL, its effects on general, psychological, sexual, and vasomotor symptoms QoL scores as well as the effect of PFMT on general QoL were not significant. Our findings suggest that well-designed studies are needed to confirm the effect of exercise on QoL in women with menopausal symptoms.

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