Does combined lithotripter show superior stone-success rate than ultrasonic or pneumatic device alone during percutaneous nephrolithotrotomy? A meta-analysis

2022 ◽  
pp. 106223
Author(s):  
Lede Lin ◽  
Liang Zhou ◽  
Kaiwen Xiao ◽  
Xi Jin ◽  
Zhongyu Jian ◽  
...  
Keyword(s):  
Success Rate ◽  
Meta Analysis ◽  
Pneumatic Device

scholarly journals Pre-Procedural Lumbar Neuraxial Ultrasound—A Systematic Review of Randomized Controlled Trials and Meta-Analysis

Healthcare ◽  
2021 ◽  
Vol 9 (4) ◽  
pp. 479
Author(s):  
Tatiana Sidiropoulou ◽  
Kalliopi Christodoulaki ◽  
Charalampos Siristatidis
Keyword(s):  
Systematic Review ◽  
Lumbar Spine ◽  
Randomized Controlled Trials ◽  
Success Rate ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Technical Failure ◽  
Obese Patients ◽  
Randomized Controlled ◽  
Meta Analyses

A pre-procedural ultrasound of the lumbar spine is frequently used to facilitate neuraxial procedures. The aim of this review is to examine the evidence sustaining the utilization of pre-procedural neuraxial ultrasound compared to conventional methods. We perform a systematic review of randomized controlled trials with meta-analyses. We search the electronic databases Medline, Cochrane Central, Science Direct and Scopus up to 1 June 2019. We include trials comparing a pre-procedural lumbar spine ultrasound to a non-ultrasound-assisted method. The primary endpoints are technical failure rate, first-attempt success rate, number of needle redirections and procedure time. We retrieve 32 trials (3439 patients) comparing pre-procedural lumbar ultrasounds to palpations for neuraxial procedures in various clinical settings. Pre-procedural ultrasounds decrease the overall risk of technical failure (Risk Ratio (RR) 0.69 (99% CI, 0.43 to 1.10), p = 0.04) but not in obese and difficult spinal patients (RR 0.53, p = 0.06) and increase the first-attempt success rate (RR 1.5 (99% CI, 1.22 to 1.86), p < 0.0001, NNT = 5). In difficult spines and obese patients, the RR is 1.84 (99% CI, 1.44 to 2.3; p < 0.0001, NNT = 3). The number of needle redirections is lower with pre-procedural ultrasounds (SMD = −0.55 (99% CI, −0.81 to −0.29), p < 0.0001), as is the case in difficult spines and obese patients (SMD = −0.85 (99% CI, −1.08 to −0.61), p < 0.0001). No differences are observed in procedural times. Ιn conclusion, a pre-procedural ultrasound provides significant benefit in terms of technical failure, number of needle redirections and first attempt-success rate. Τhe effect of pre-procedural ultrasound scanning of the lumbar spine is more significant in a subgroup analysis of difficult spines and obese patients.

447 What Age is Best to Perform Myringoplasty?

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
L Wilks ◽  
R Mcleod ◽  
V Unadkat
Keyword(s):  
Systematic Review ◽  
Success Rate ◽  
Meta Analysis ◽  
Paediatric Population ◽  
Cochrane Library ◽  
Clear Correlation ◽  
Success Rates ◽  
Prisma Statement ◽  
Transitional Point ◽  
The Cochrane Library

Abstract Aim This systematic review and meta-analysis aims to assess this relationship and determine the most appropriate age for recommendation of surgery. Method According to the “Preferred Reporting items for systematic review and meta-analysis” (PRISMA) statement, a literature search was performed across Medline, EMBASE and the Cochrane library from 1946-2018. Articles examining a relationship between age and myringoplasty or type 1 tympanoplasty success rates were screened. Results 20 articles encompassing data from 2244 procedures were included. The overall results conveyed a clear correlation between increasing age and rising success rate. A t-test was conducted which demonstrated a significant (P = 0.05) transition at aged 10, whereby success rate below age 10 was 70.6% and above 10 was 86%. Conclusions This systematic review and meta-analysis has uncovered a clear correlation between increasing age and increasing success rate for myringoplasty in the paediatric population. Furthermore, a significant transitional point has been demonstrated at the age of 10 and We hope that knowledge of increased success rates particularly after the age of 10 helps clinicians make more informed decisions about when to operate

Abstract 16680: Endovascular Therapy of Svc Syndrome-a Systematic Review

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Abdul Hussain Azizi ◽  
Irfan Shafi ◽  
Matthew Zhao ◽  
Vladimir Lakhter ◽  
Riyaz Bashir
Keyword(s):  
Systematic Review ◽  
Success Rate ◽  
Recurrence Rate ◽  
Endovascular Therapy ◽  
Meta Analysis ◽  
Restenosis Rate ◽  
Technical Success ◽  
Recurrence Rates ◽  
Technical Success Rate ◽  
Svc Syndrome

Background: Superior vena cava (SVC) syndrome is caused by the occlusion of the SVC and can result in significant morbidity and mortality. Recently, endovascular therapy (ET) has become the standard of care for majority of these patients. We performed a systematic review of available literature to assess the contemporary technical success rate, restenosis rate, and recurrence rate of SVC syndrome following endovascular intervention. Methods: We searched PubMed, Cochrane Library, and Embase databases from 1988 to 2019 for studies on Endovascular Therapy for SVC syndrome. After screening 709 records, 13 studies were included. Screening was conducted using Rayyan QCRI software for systemic reviews. Studies included full-length journal articles on SVC syndrome and ET among adults (18+ years). Case reports, or case series with <20 patients were excluded. Data analysis was performed using OpenMeta software. Proportions and 95% confidence intervals (CIs) were calculated using random effects models. Heterogeneity among studies was assessed using Q and I 2 statistics. We evaluated the end-points of the technical success, restenosis rate and recurrence rates in SVC syndrome patients after endovascular stenting Results: A meta-analysis of 13 studies included a total of 1024 patients. The results of our meta-analysis show a weighted technical success rate of 98.6% (95% CI 0.97 – 0.99) (Fig. 1A), restenosis rate of 11.8% (95 CI 0.08-0.14) (Fig 1B) and recurrence rate of 9.9% (95% CI 0.06-0.13) (Fig 1C). Our studies had a substantial heterogeneity (I 2 ) of 52-80%. Figures:Figure 1A Figure 1B Figure 1C Conclusions: Our systematic review revealed high technical success rate, low restenosis, and recurrence rates after endovascular therapy supporting the paradigm of endovascular therapy as first line treatment for patients with SVC syndrome. Disclosures: Dr. Bashir has equity interest in Thrombolex Inc.

Abstract 523: Ultrasound Assisted Thrombolysis Versus Catheter Directed Thrombolysis: A Meta-Analysis

2017 ◽  
Vol 37 (suppl_1) ◽  
Author(s):  
Syed Imran M Zaidi ◽  
Abdul Ahad Khan ◽  
Hemang B Panchal ◽  
Zulfiqar Qutrio Baloch ◽  
Enambir Josan ◽  
...  
Keyword(s):  
Success Rate ◽  
Meta Analysis ◽  
Ultrasonic Energy ◽  
Short Term ◽  
Bleeding Events ◽  
Thrombolytic Agents ◽  
Catheter Directed Thrombolysis ◽  
Pubmed Database ◽  
Ultrasound Assisted

Introduction: Deep venous thrombosis (DVT) and pulmonary embolism (PE) have many methods of treatment including anti-coagulation, thrombectomy and thrombolysis. Thrombolysis can be achieved via systemic or local thrombolytic agents, with standard local thrombolysis achieved via catheter insertion in proximity to the thrombus and delivery of thrombolytic agents. Ultrasound-assisted catheter thrombolysis (UAT) is a relatively newer form of thrombolysis which utilizes ultrasonic energy, along with local thrombolytics to help in thrombus breakdown. The objective of our meta-analysis is to compare UAT and catheter directed thrombolysis (CDT) for treatment of DVT and PE. Methods: PubMed database was searched through January 2017. Three studies (n=156) comparing UAT (n=99) and CDT (n=57) for thrombolysis were included. End points were > 50% thrombus lysis, bleeding (moderate and severe), and mortality on short term follow up (<1 year). The relative risk (RR) or mean difference (MD) with 95% confidence interval (CI) was computed and p<0.05 was considered as a level of significance. Results: Thrombolysis success rate was similar with UAT and CDT (RR 1.06, CI 0.89-1.27, p=0.49). Moderate and severe bleeding events were similar with both groups (RR 0.71, CI 0.27-1.87, p=0.49). Mortality on short term follow up was significantly lower in UAT as compared to CDT (RR 0.47, CI 0.23-0.95, p=0.04). Conclusions: The results of our meta-analysis demonstrated no difference in thrombolysis success rate or bleeding events when using UAT Vs CDT, however short term mortality was significantly lower with UAT. Further controlled trials with larger sample sizes are required to assess the possible benefit of using ultrasonic energy for venous thrombolysis.

Comparison between Ologen implant and Mitomycin C in trabeculectomy: A Systematic Review and Meta-Analysis

2019 ◽  
Author(s):  
Xiaoyan Liu ◽  
Yali Du ◽  
Min Lei ◽  
Leyi Zhuang ◽  
Peng Lv
Keyword(s):  
Adverse Events ◽  
Success Rate ◽  
Data Extraction ◽  
Meta Analysis ◽  
Collagen Matrix ◽  
Current Evidence ◽  
Cochrane Library ◽  
Significant Difference ◽  
Mean Differences ◽  
Alternative Choice

Abstract Objective To evaluate the effectiveness and safety of the biodegradable collagen matrix (Ologen) implant in trabeculectomy. Research design and methods We searched Pubmed, Cochrane library, Embase and Web of Science databases to find studies that met our pre-stated inclusion criteria. Reference lists of retrieved articles were also reviewed. The search was finished by February 2019. Study selection, data extraction, quality assessment, and data analyses were performed according to the Cochrane standards. Either a fixed or a random-effects model was used to calculate the overall combined risk estimates. The efficacy measures were the weighted mean differences (WMDs) for the intraocular pressure reduction (IOPR) and the glaucoma medications reduction, the odds ratio (OR) for the success rate and adverse events. Results Fifteen randomized controlled trials involved 682 eyes were included in the meta-analysis. There were no statistically differences between two groups in the IOPR at any time postoperatively. The MD of the IOPR was [MD= -0.45,95% Confidence Interval (CI), (-2.36,1.46), P=0.65] at one day, [MD= -0.82,95% CI, (-1.97, 0.33), P=0.16] at one week, [MD= -1.33, 95% CI,(-3.12, 0.47), P=0.15] at one month, [MD= 0.11,95% CI, (-1.87, 2.08), P=0.92] at three months, [MD= -0.60,95% CI, (-2.27, 1.06), P=0.48] at six months, [MD= -0.33,95% CI, (-1.99, 1.32), P=0.69] at one year, [MD= -0.13,95% CI, (-1.90, 1.65), P=0.89] at two years, [MD= 2.54,95% CI, (-2.83, 7.90), P=0.35] at three years, [MD= 3.04,95% CI, (-3.95, 10.03), P=0.39] at five years. There was no statistically significant difference between the Ologen groups and MMC groups concerned the complete success rate [OR=1.19, 95%CI, (0.83, 1.71), P=0.35]. With regard to the adverse events, no obvirously significance was observed. Seven studies reported the change of antiglaucoma medications. We found that the change of antiglaucoma medications is higher in MMC groups than that in Ologen groups [MD=-0.18, 95%CI, (-0.33, -0.03), P=0.02]. There is no significant difference in complications between the two groups. Conclusions From the current evidence, Ologen may be an alternative choice for trabeculectomy when considering the efficacy and safety. However, MMC might be the preferred choice concerned cost-effectiveness.

Comparison of conservative treatment with appendectomy for acute uncomplicated pediatric appendicitis: a meta-analysis

2019 ◽  
Vol 8 (10) ◽  
pp. 767-780
Author(s):  
Le-wee Bi ◽  
Bei-lei Yan ◽  
Qian-yu Yang ◽  
Hua-lei Cui
Keyword(s):  
Statistical Analysis ◽  
Treatment Group ◽  
Conservative Treatment ◽  
Success Rate ◽  
Treatment Efficacy ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Significant Difference ◽  
The Cochrane Library

Aim: We aimed to compare conservative treatment with surgery for uncomplicated pediatric appendicitis to estimate effectiveness and safety. Methods: Data recorded until September 2018 were searched, and relevant academic articles from PubMed, EMBASE, the Cochrane Library and other libraries were selected. STATA version 13.0 (Stata Corporation, TX, USA) was used for statistical analysis. Results: We identified nine eligible papers. The study reported a significant difference in the success rate of treatment in 1 month and in 1 year, and no difference in the incidence of complications. The patients with fecaliths showed low treatment efficacy in conservative treatment group (p < 0.05). Conclusion: Standardized conservative treatment as inpatients for pediatric appendicitis is safe and feasible. Appendectomy was the better choice for patients with fecaliths.

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