scholarly journals Comparison radical surgery versus conservative surgery to decrease post-operative recurrence in ossifying fibroma: systematic review

2020 ◽  
Vol 26 (4) ◽  
pp. 44
Author(s):  
Marlinda Adham ◽  
Dwi Juliana Dewi
Keyword(s):  
Systematic Review ◽  
Recurrence Rate ◽  
Radical Surgery ◽  
Case Series ◽  
Conservative Surgery ◽  
Cochrane Library ◽  
Ossifying Fibroma ◽  
Retrospective Case ◽  
Juvenile Ossifying Fibroma ◽  
First Choice

Background: Ossifying fibroma in craniofacial is a rare disease, benign, locally aggressive fibro-osseous tumor. In the recent 2017 WHO classifications, ossifying fibroma divided into 2 type, ossifying fibroma of odontogenic origin and juvenile ossifying fibroma. Choosing the right treatment that can reduce the recurrence rate are particularly challenging. In this systematic review we try to analyse related study to determine the best treatment for ossifying fibroma. Aim: The aim of this review to evaluate best treatment option and analysed level of recurrence in each type of treatment. Method: Collected Juvenile Ossifying Fibroma (JOF) and Ossifying Fibroma (OF) related Article from four different database (PubMed, Scopus, Cochrane Library, and Proquest). Study selection was done by using PRISMA strategy. Result: Eight retrospective case series studies were analyzed. Recurrence rate after surgery was 15.3%, most frequent recurrence occurs in conservative surgery. Recurrence rate after conservative surgery was 19.7%, compared with radical surgery which relatively lower in percentage, with recurrence rate after surgery was 10.6%. Conclusion: Juvenile Ossifying Fibroma, especially Trabecular Juvenile Ossifying Fibroma (TrJOF), show high recurrence percentage comparing other type. The first-choice management for treating OF was surgical approach. Types of surgery choose to depend on the aggressiveness and morbidity of the disease. Radical surgery was proven better to decrease level of recurrence compared with conservative surgery.

Recurrence Rate After Wide Resection of Plantar Fibromatosis: A Case Series and Systematic Literature Review

2021 ◽  
pp. 193864002110320
Author(s):  
Helen Anwander ◽  
Florian Weichsel ◽  
Jennifer Cullmann ◽  
Angela Seidel ◽  
Annabel Hayoz ◽  
...  
Keyword(s):  
Systematic Review ◽  
Recurrence Rate ◽  
Case Series ◽  
Local Resection ◽  
Wide Resection ◽  
Foot And Ankle ◽  
Retrospective Case ◽  
American Orthopaedic ◽  
Plantar Fibromatosis

Background The aim was to assess the recurrence rate and clinical outcome after wide resection for plantar fibromatosis. Methods A total of 12 patients, 2 to 13 years after wide resection, were assessed for local and magnetic resonance imaging tomographic signs of recurrence at the clinical follow-up. In addition, a systematic review of the literature was conducted. Results After 7.8 years (2-13), 2 patients (17%) suffered a recurrence. At the last follow-up, median Foot Functional Index was 1 (0-66) and American Orthopaedic Foot and Ankle Society score was 95 (44-100). Six studies with 109 feet (92 patients) were included in the systematic review. The recurrence rate depends on the width of the resection: 67% after local resection, 42% after wide resection, and 27% after fasciectomy. Conclusion In patients with symptomatic plantar fibromatosis, we recommend a wide resection or fasciectomy over a local resection because of the inferior recurrence rate. Levels of Evidence Level IV: Retrospective case series

Use of Local Flaps for Soft-Tissue Closure in Diabetic Foot Wounds: A Systematic Review

2018 ◽  
Vol 12 (3) ◽  
pp. 286-293 ◽  
Author(s):  
Crystal L. Ramanujam ◽  
Thomas Zgonis
Keyword(s):  
Systematic Review ◽  
Diabetic Foot ◽  
English Language ◽  
Wound Closure ◽  
Revisional Surgery ◽  
Data Extraction ◽  
Case Series ◽  
Cochrane Library ◽  
Retrospective Case

“A systematic review was undertaken to assess the outcomes of local random flaps in diabetic foot wound closure. The review was conducted using the following databases: Cumulative Index of Nursing and Allied Health Literature, Cochrane Library, Excerpta Medica dataBASE, Google Scholar, MEDLINE, Ovid, and PubMed. Search terms were local random flap, diabetes, foot, wound, ulceration, neuropathy, tissue transfer, V-Y, bilobed, monolobed, rotational, advancement, transpositional, rhomboid, and Limberg. English language studies, studies published from 1997 to 2017, patients with diabetes mellitus treated for foot wounds, use of local random flaps, follow-up period of 6 months or more postoperatively, documentation of healing rates, complications, and need for revisional surgery were included. Isolated literature reviews and descriptions of only surgical technique and/or cadaveric studies were excluded. The initial search identified 53 eligible studies with 28 being excluded. The remaining 25 studies used for data extraction had a total of 512 patients in which 199 of these underwent 204 local random flap procedures. Average follow-up for the flaps was approximately >2 years, and successful wound closure at last follow-up was demonstrated in 75.5% of the studied population. Studies were found to be of generally low quality, with the majority composed of retrospective case series. Based on current available evidence found in this systematic review, local random flaps demonstrated a relatively high success rate when utilized for the definitive closure of diabetic foot wounds. However, because of a lack of high-quality evidence and substantial heterogeneity among the studies, the results should be interpreted with caution. Levels of Evidence: Level III: Systematic review

scholarly journals The autoclaving and re-implantation of an infected prosthesis as a spacer during resection knee arthroplasty: a systematic review

2021 ◽  
Author(s):  
Antonio Spinarelli ◽  
Davide Bizzoca ◽  
Lorenzo Moretti ◽  
Giovanni Vicenti ◽  
Raffaele Garofalo ◽  
...  
Keyword(s):  
Systematic Review ◽  
Infection Rate ◽  
Comparative Studies ◽  
Case Series ◽  
Cochrane Library ◽  
Range Of Movement ◽  
Retrospective Case ◽  
Level Of Evidence ◽  
Joint Infections ◽  
Articulating Spacer

Abstract Background Hofmann et al., in 1995, first described an articulating spacer made by cleaning and autoclaving the original femoral component, which is then re-implanted with a new tibial polyethylene. This systematic review aims to assess the state of existing evidence on the intraoperative autoclaving and re-use of an infected prosthesis, as a spacer, during a two-stage revision following Periprosthetic Joint Infections (PJI). Methods A systematic review was conducted with methods described in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. OVID-MEDLINE®, EMBASE, Cochrane Library, SCOPUS, Web of Science, Google Scholar and PubMed were searched from 1995 to April 2020 to identify relevant studies. Results Fourteen studies were included in this systematic review: two prospective case series; six retrospective comparative studies and six retrospective case series. The reviewed studies included 567 patients (571 knees): 394 patients treated with autoclaved components and 173 with a spacer made of new components. The cumulative re-infection rate in patients treated with re-used autoclaved components was 13.7% (54 re-infections in 394 patients), whereas in control patients the re-infection rate was 13.3% (23 re-infections in 173 patients). The final Range of Movement in patients treated using the autoclaved components as a spacer, compared with patients receiving static spacers, was significantly higher in three out of four comparative studies. Conclusion There is a moderate level of evidence that the intraoperative autoclaving and re-use of an infected prosthesis as a spacer, during a knee resection arthroplasty, is an effective procedure in the management of knee PJI.

scholarly journals Does the Type of Sport Influence Morphology of the Hip? A Systematic Review

2021 ◽  
pp. 036354652110235
Author(s):  
Chantelle Doran ◽  
Matthew Pettit ◽  
Yash Singh ◽  
Karadi Hari Sunil Kumar ◽  
Vikas Khanduja
Keyword(s):  
Systematic Review ◽  
Case Reports ◽  
Alpha Angle ◽  
Case Series ◽  
Activity Level ◽  
Ice Hockey ◽  
Cochrane Library ◽  
Retrospective Case ◽  
Level Of Evidence ◽  
Hip Morphology

Background: Femoroacetabular impingement (FAI) has been extensively investigated and is strongly associated with athletic participation. Purpose: To assess (1) the prevalence of cam-type FAI across various sports; (2) whether kinematic variation among sports influences hip morphology; and (3) whether performance level, duration, and frequency of participation or other factors influence hip morphology in a sporting population. Study Design: Systematic review; Level of evidence, 4. Methods: A systematic search of Embase, PubMed, and the Cochrane Library was undertaken following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Prospective and retrospective case series, case reports, and review articles published after 1999 were screened, and those that met the inclusion criteria decided a priori were included for analysis. Results: The literature search identified 58 relevant articles involving 5683 participants. A total of 49 articles described a higher prevalence of FAI across various “hip-heavy” sports, including soccer, basketball, baseball, ice hockey, skiing, golf, and ballet. In studies including nonathlete controls, a greater prevalence of FAI was reported in 66.7% of studies (n = 8/12). The highest alpha angle was identified at the 1-o’clock position (n = 9/9) in football, skiing, golf, ice hockey, and basketball. The maximum alpha angle was located in a more lateral position in goalkeepers versus positional players in ice hockey (1 vs 1:45 o’clock). A positive correlation was also identified between the alpha angle and both age and activity level (n = 5/8 and n = 2/3, respectively) and between prevalence of FAI and both age and activity level (n = 2/2 and n = 4/5). Conclusion: Hip-heavy sports show an increased prevalence of FAI, with specific sporting activities influencing hip morphology. There is some evidence to suggest that a longer duration and higher level of training also result in an increased prevalence of FAI. Registration: CRD4202018001 (PROSPERO).

Same-Admission Microvascular Maxillofacial Ballistic Trauma Reconstruction Using Virtual Surgical Planning: A Case Series and Systematic Review

2021 ◽  
pp. 194338752110264
Author(s):  
Sean A. Knudson ◽  
Kristopher M. Day ◽  
Patrick Kelley ◽  
Pablo Padilla ◽  
Ian X. Collier ◽  
...  
Keyword(s):  
Systematic Review ◽  
Surgical Planning ◽  
Average Length ◽  
Case Series ◽  
Retrospective Case ◽  
Oral Nutrition ◽  
Microsurgical Reconstruction ◽  
Virtual Surgical Planning ◽  
And Function ◽  
Ballistic Trauma

Study Design: Retrospective case series; systematic review. Objective: It is unknown whether the use of virtual surgical planning (VSP) to facilitate same-admission microsurgical reconstruction of the mandible following acute maxillofacial ballistic trauma (MBT) is sufficient to achieve definitive reconstruction and functional occlusion. Methods: A single-center retrospective analysis was conducted for patients who underwent microsurgical reconstruction of the mandible using VSP after acute MBT. The PubMed/MEDLINE, Embase, ScienceDirect, and Scopus databases were systematically reviewed using blinded screening. Studies were evaluated via thematic analysis. Results: Five patients were treated by same-admission and microsurgical reconstruction of the mandible using VSP. We observed an average of 16.4 ± 9.1 days between initial presentation and reconstruction, an average length of stay of 51.6 ± 17.9 days, 6.2 ± 2.8 operations, and 1.6 ± 0.9 free flaps per patient. Four types and 8 total flaps were employed, most commonly the anterior lateral thigh flap (37.5%). Care yielded complete flap survival. Each patient experienced at least 1 minor complication. All patients achieved centric occlusion, oral nutrition, and an approximation of their baseline facial aesthetic. Follow up was 191.0 ± 183.9 weeks. Systematic review produced 8 articles that adhered to inclusion criteria. Consensus themes in the literature were found for clinical goal and function of VSP when practicing MBT reconstruction, yet disagreement was found surrounding optimal treatment timeline. Conclusions: Same-admission microsurgical reconstruction after MBT is safe and effective to re-establish mandibular form and function. VSP did not delay reconstruction, given the need for preparation prior to definitive reconstruction.

scholarly journals Least possible fixation techniques of 4-part valgus impacted fractures of the proximal humerus: a systematic review

2016 ◽  
Vol 8 (1) ◽  
Author(s):  
Andreas Panagopoulos ◽  
Irini Tatani ◽  
Dimitrios Ntourantonis ◽  
Ioannis Seferlis ◽  
Antonis Kouzelis ◽  
...  
Keyword(s):  
Systematic Review ◽  
Avascular Necrosis ◽  
Proximal Humerus ◽  
Constant Score ◽  
Surgical Techniques ◽  
Case Series ◽  
Cochrane Library ◽  
Operation Rate ◽  
Fixation Techniques

The valgus-impacted (VI) 4-part fractures are a subset of fractures of the proximal humerus with a unique anatomic configuration characterized by a relatively lower incidence of avascular necrosis after operative intervention. We systematically reviewed clinical studies assessing the benefits and harms of least possible fixation techniques (LPFT) for this unique fracture type. Such information would be potentially helpful in developing an evidence-based approach in the management of these complex injuries. We performed analytic searches of PubMed, Embase, Web of Science, Google Scholar and the Cochrane Library, restricting it to the years 1991-2014. Included studies had to describe outcomes and complications after primary osteosynthesis with any type of LPFT apart from plate-screws and intramedullary nailing. Eligibility criteria were also included English language, more than 5 cases, minimum follow up of one year and report of clinical outcome using at least one relevant score (Constant, Neer or ASES). Based on 292 database hits we identified 12 eligible studies including 190 four-part valgus impacted fractures in 188 patients. All eligible studies were case series composed of min 8 to max 45 patients per study. The gender distribution was 60% (112) female and 40% (76) male. The average age of the patients at the time of injury was 54.5 years. In 8/12 studies an open reduction was used for fracture fixation using different surgical techniques including KW, cerclage wires, cannulated screws and osteosutures. Closed reduction and percutaneous fixation was used in 4 studies. Mean follow-up time ranged from 24 to 69 months. A good functional outcome (constant score >80) was reported in 9/12 studies. The most common complication was avascular necrosis of the humeral head with an overall incidence of 11% (range, 0-26.3%). Total avascular necrosis (AVN) was found in 15/188 patients (7.9%) and was more common in percutaneous techniques and partial AVN in 6/188 (3.1%) being more common in open techniques. The overall re-operation rate was very low (3.7%). Insufficient study designs cannot provide definite treatment recommendations and quantitative data synthesis of outcome. In general, LPFT for 4-part VI fractures leads to satisfactory outcomes with low incidence of complications. A considerable risk of biases can be attributed to fracture classification, proper radiological control, mean age of patients, mixed types of fixation methods, nonage adjusted clinical scoring and small follow up periods. These factors are discussed in detail. Level of evidence: systematic review of literature (level IV) as most of the studies were level IV.

Comparison of Corticosteroid and Vincristine in Treating Kaposiform Hemangioendothelioma and Tufted Angioma: A Systematic Review and Meta-Analysis

2018 ◽  
Vol 29 (05) ◽  
pp. 401-407 ◽  
Author(s):  
Wei Yao ◽  
Kai Li ◽  
Zuopeng Wang ◽  
Jiahao Pei ◽  
Xiangqi Liu ◽  
...  
Keyword(s):  
Recurrence Rate ◽  
Adverse Reactions ◽  
Meta Analysis ◽  
Case Series ◽  
Research Quality ◽  
Cochrane Library ◽  
Kaposiform Hemangioendothelioma ◽  
Systemic Corticosteroids ◽  
Tufted Angioma

Objective To evaluate the outcome and safety of corticosteroids and vincristine (VCR) in the treatment of kaposiform hemangioendothelioma (KHE) and tufted angioma (TA). Materials and Methods Clinical studies involving corticosteroids and VCR therapies in treating KHE/TA were identified by using PubMed, Cochrane Library, OVID, EBSCO, CNKI, VIP, and Wanfang databases from their establishment date to December 2017. Randomized controlled trials, case–control, or case series with more than five cases were included. The following data were extracted: study sample, demographics, responses rate, recurrence rate, and adverse reactions. Two reviewers completed screening and extraction. Methodological quality was evaluated with quality appraisal tool. Results A total of 266 studies were found, and 27 studies were finally included in this research; quality of all studies was low. Seven studies with a total of 123 participants, which compared the effect of systemic corticosteroids with that of VCR, were performed for the meta-analysis. The results indicated that the effect of VCR was significantly higher than that of corticosteroids (relative risk [RR] = 2.08, 95% confidence interval [CI]: 1.38–3.16). The recurrence rate of VCR (11.1%) was lower than that of corticosteroids (50%), but there was no statistical difference between the two therapies (p = 0.1312). The result of pooled adverse reactions response rate for VCR was 18.2%, significantly lower than that for corticosteroids, which was 52.0%. Conclusion The present profile shows that VCR is relatively more effective and safer in treating KHE/TA than corticosteroids are. So, we believe VCR could be used as a first-line medication agent in the treatment of KHE/TA.

Recurrence Rate of Sporadic Pheochromocytomas After Curative Adrenalectomy: A Systematic Review and Meta-analysis

2020 ◽  
Author(s):  
Isabelle Holscher ◽  
Tijs J van den Berg ◽  
Koen M A Dreijerink ◽  
Anton F Engelsman ◽  
Els J M Nieveen van Dijkum
Keyword(s):  
Systematic Review ◽  
Recurrence Rate ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Weighted Mean ◽  
Curative Surgery ◽  
Endocrine Society ◽  
Time To Recurrence ◽  
The Cochrane Library

Abstract Background Evidence on follow-up duration for patients with sporadic pheochromocytomas is absent, and current guidelines of the European Society of Endocrinology, American Association of Clinical Endocrinologists and Endocrine Surgeons, and the Endocrine Society are ambiguous about the appropriate duration of follow-up. The aim of this systematic review and meta-analysis is to evaluate the recurrence rate of sporadic pheochromocytomas after curative adrenalectomy. Materials and Methods A literature search in PubMed, Embase, and the Cochrane Library was performed. A study was eligible if it included a clear report on the number of sporadic patients, recurrence rate, and follow-up duration. Studies with an inclusion period before 1990, <2 years of follow-up, <10 patients, and unclear data on the sporadic nature of pheochromocytomas were excluded. A meta-analysis on recurrence was performed provided that the heterogeneity was low (I2 < 25%) or intermediate (I2 26–75%). Hozo’s method was used to calculate weighted mean follow-up duration and weighted time to recurrence with combined standard deviations (SDs). Results A total of 13 studies, including 430 patients, were included in the synthesis. The meta-analysis results describe a pooled recurrence rate after curative surgery of 3% (95% confidence interval: 2–6%, I2 = 0%), with a weighted mean time to recurrence of 49.4 months (SD = 30.7) and a weighted mean follow-up period of 77.3 months (SD = 32.2). Conclusions This meta-analysis shows a very low recurrence rate of 3%. Prospective studies, including economical and health effects of limited follow-up strategies for patients with truly sporadic pheochromocytomas should be considered.

Rituximab for Eosinophilic Granulomatosis with Polyangiitis: a Systematic Review of Observational Studies

Rheumatology ◽  
2021 ◽  
Author(s):  
Vincenzo G Menditto ◽  
Giulia Rossetti ◽  
Diletta Olivari ◽  
Alessia Angeletti ◽  
Marco Rocchi ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cohort Studies ◽  
Granulomatosis With Polyangiitis ◽  
Case Reports ◽  
Case Series ◽  
Biologic Agents ◽  
Cochrane Library ◽  
Eosinophilic Granulomatosis With Polyangiitis ◽  
Extensive Literature ◽  
Eosinophilic Granulomatosis

Abstract Objective to analyze the available evidence about the use of rituximab (RTX) and other biologic agents in Eosinophilic Granulomatosis with Polyangiitis (EGPA) patients and to provide useful findings to inform the design of future, reliable clinical trials. Methods A systematic review was performed. A systematic search was conducted in PubMed/MEDLINE, Scopus, Web of Science and the Cochrane library databases and an extensive literature search on other biologic agents. Results 45 papers pertinent to our questions were found: 16 retrospective cohort studies, 8 case series, 3 prospective cohort studies and 18 single case reports, for a total of 368 EGPA patients. More than 80% of evaluable patients achieved complete or partial remission with a tendency towards a higher rate of complete response in pANCA positive subgroup. Conclusion Although the majority of the evaluable EGPA patients treated with RTX appears to achieve complete remission, we strongly believe that a number of sources of heterogeneity impairs a clear interpretation of results and limits their transferability in clinical practice. Differences in design, enrollment criteria, outcome definition and measurement make a comparison among data obtained from studies on RTX and other biologic agents unreliable.

scholarly journals The impact of decision aids in patients with colorectal cancer: a systematic review

BMJ Open ◽  
2019 ◽  
Vol 9 (9) ◽  
pp. e028379 ◽  
Author(s):  
Jenaya Goldwag ◽  
Priscilla Marsicovetere ◽  
Peter Scalia ◽  
Heather A Johnson ◽  
Marie-Anne Durand ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Systematic Review ◽  
Cancer Treatment ◽  
Data Extraction ◽  
Decision Aids ◽  
Case Series ◽  
Cochrane Library ◽  
Eligibility Criteria ◽  
The Impact ◽  
Colorectal Cancer Treatment

ObjectivesOur aim was to conduct a systematic review of the literature to determine the impact of patient decision aids (PDA) on patients facing treatment decisions for colorectal cancer.DesignSystematic review.Data sourcesSources included Embase, Medline, Web of Science, CINAHL and the Cochrane Library from inception to June, 20, 2019.Eligibility criteriaWe included randomised controlled trials (RCTs), cohort studies, mixed methods and case series in which a PDA for colorectal cancer treatment was used. Qualitative studies were excluded from our review.Data extraction and synthesisFollowing execution of the search strategy by a medical librarian, two blinded independent reviewers identified articles for inclusion. Two blinded reviewers were also responsible for data extraction, risk of bias and study quality assessments. Any conflict in article inclusion or extraction was resolved by discussion.ResultsOut of 3773 articles identified, three met our inclusion criteria: one RCT, one before-and-after study and one mixed-method study. In these studies, the use of a PDA for colorectal cancer treatment was associated with increased patient knowledge, satisfaction and preparation for making a decision. On quality assessment, two of three studies were judged to be of low quality.ConclusionA paucity of evidence exists on the effect of PDA for colorectal cancer treatment with existing evidence being largely of low quality. Further investigation is required to determine the effect of decision aids for colorectal cancer treatment as well as reasons for the lack of PDA development and implementation in this area.Prospero registration numberCRD42018095153.

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