scholarly journals Suture rectopexy versus ventral mesh rectopexy for complete full-thickness rectal prolapse and intussusception: systematic review and meta-analysis

BJS Open ◽  
2021 ◽  
Vol 5 (1) ◽  
Author(s):  
H S Lobb ◽  
C C Kearsey ◽  
S Ahmed ◽  
R Rajaganeshan
Keyword(s):  
Systematic Review ◽  
Rectal Prolapse ◽  
Recurrence Rate ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Complete Rectal Prolapse ◽  
Recurrence Rates ◽  
Suture Rectopexy ◽  
Ventral Mesh Rectopexy ◽  
Mesh Rectopexy

Abstract Background This systematic review and meta-analysis aimed to compare recurrence rates of rectal prolapse following ventral mesh rectopexy (VMR) and suture rectopexy (SR). Methods MEDLINE, Embase, and the Cochrane Library were searched for studies reporting on the recurrence rates of complete rectal prolapse (CRP) or intussusception (IS) after SR and VMR. Results were pooled and procedures compared; a subgroup analysis was performed comparing patients with CRP and IS who underwent VMR using biological versus synthetic meshes. A meta-analysis of studies comparing SR and VMR was undertaken. The Methodological Items for Non-Randomized Studies score, the Newcastle–Ottawa Scale, and the Cochrane Collaboration tool were used to assess the quality of studies. Results Twenty-two studies with 976 patients were included in the SR group and 31 studies with 1605 patients in the VMR group; among these studies, five were eligible for meta-analysis. Overall, in patients with CRP, the recurrence rate was 8.6 per cent after SR and 3.7 per cent after VMR (P < 0.001). However, in patients with IS treated using VMR, the recurrence rate was 9.7 per cent. Recurrence rates after VMR did not differ with use of biological or synthetic mesh in patients treated for CRP (4.1 versus 3.6 per cent; P = 0.789) and or IS (11.4 versus 11.0 per cent; P = 0.902). Results from the meta-analysis showed high heterogeneity, and the difference in recurrence rates between SR and VMR groups was not statistically significant (P = 0.76). Conclusion Although the systematic review showed a higher recurrence rate after SR than VMR for treatment of CRP, this result was not confirmed by meta-analysis. Therefore, robust RCTs comparing SR and biological VMR are required.

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.

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.

scholarly journals Recurrence Rates After Microvascular Decompression in Patients With Primary Trigeminal Neuralgia and Its Influencing Factors: A Systematic Review and Meta-Analysis Based on 8,172 Surgery Patients

2021 ◽  
Vol 12 ◽  
Author(s):  
Fangyu Chen ◽  
Yuming Niu ◽  
Fan Meng ◽  
Pan Xu ◽  
Chao Zhang ◽  
...  
Keyword(s):  
Systematic Review ◽  
Trigeminal Neuralgia ◽  
Recurrence Rate ◽  
Influencing Factors ◽  
Microvascular Decompression ◽  
Meta Analysis ◽  
Postoperative Recurrence ◽  
Recurrence Rates ◽  
Primary Trigeminal Neuralgia

Background: Primary trigeminal neuralgia (PTN) is known to reoccur following microvascular decompression (MVD) surgery. However, the rates and contributing factors related to PTN recurrence remain controversial. The purpose of this study was to explore the postoperative recurrence rates and related influencing factors of patients with PTN after MVD. Additionally, recurrence rates after different treatments were compared to provide guidelines for clinicians.Methods: We conducted systematic reviews and meta-analyses in accordance with the preferred reporting items of the PRISMA guidelines. We searched nine databases, namely, the PubMed, EMBASE, Cochrane Library, Web of Science, CINAHL, CBM, CNKI, VIP, and Wanfang databases, from establishment to July 13, 2020, selecting for studies about the long-term postoperative efficacy of MVD in the treatment of PTN. Factors associated with higher recurrence rates after MVD and long-term postoperative results of other treatments underwent formal meta-analysis, where odds ratios (ORs) with the corresponding 95% confidence intervals (CIs) were calculated. The dose-response model was used to inspect the associations between several factors and higher recurrence rates.Results: Seventy-four studies (8,172 patients, 32 case series studies, and 42 non-randomized controlled trials) were analyzed in our research. Overall, 956 out of 8,172 patients relapsed, and the pooled recurrence rate was 0.096 (0.080–0.113). Influencing factors of relatively higher recurrence rates included atypical trigeminal neuralgia symptoms, lack of nerve groove, non-arterial compression, patients who were 50–60 years old, and longer disease duration. Dose–response analysis showed that the recurrence rate had a significant trend with the published year and the follow-up time. Simultaneously, the recurrence rate of MVD treatment was much lower than that of conventional drug treatment, gamma knife surgery, percutaneous balloon compression, and radiofrequency thermocoagulation. When the surgical technique was improved or combined with partial sensory rhizotomy (PSR), the postoperative recurrence rates were significantly reduced.Conclusions: Even for PTN patients who have a successful operation, ~10% of them will still relapse. This research identifies several factors that can affect the recurrence rate. Compared with other operations, MVD has a relatively lower recurrence rate. Our analysis suggests that improved surgical techniques and combining PSR and MVD will yield better results.Systematic Review Registration:https://www.crd.york.ac.uk/PROSPERO/, identifier: CRD42020159276.

scholarly journals Laparoscopic Suture versus Mesh Rectopexy for the Treatment of Persistent Complete Rectal Prolapse in Children: A Comparative Randomized Study

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
AbdelAziz Yehya ◽  
Ibrahim Gamaan ◽  
Mohamed Abdelrazek ◽  
Mohamed Shahin ◽  
Ashraf Seddek ◽  
...  
Keyword(s):  
Fecal Incontinence ◽  
Rectal Prolapse ◽  
Operative Time ◽  
Randomized Study ◽  
Complete Rectal Prolapse ◽  
University Hospitals ◽  
Laparoscopic Suture ◽  
Suture Rectopexy ◽  
Group B ◽  
Mesh Rectopexy

Purpose. To compare laparoscopic mesh rectopexy with laparoscopic suture rectopexy. Patients and Methods. The prospective study was conducted at Pediatric Surgery Department, Al-Azhar University Hospitals, Cairo, Egypt between Feb 2010 and Jan 2015. Seventy-eight children with persistent complete rectal prolapse were subjected to laparoscopic rectopexy. Fourteen parents refused to participate. All patients received initial conservative treatment for more than one year. The remaining 64 patients were randomized divided into two equal groups. Group A; 32 patients underwent laparoscopic mesh rectopexy and group B, 32 underwent laparoscopic suture rectopexy. The operative time, recurrence rate, post-operative constipation, and effect on fecal incontinence, were reported and evaluated for each group. Results. Sixty-four cases presented with persistent complete rectal prolapse were the material of this study. They were 40 males and 24 females. Mean age at operation was 8 (5–12) years. All cases were completed laparoscopically. Mean operative time in laparoscopic suture rectopexy was shorter than laparoscopic mesh rectopexy group. No early post-operative complications were encountered. No cases of recurrence with mesh rectopexy group while in suture rectopexy group it was 4 cases (14.2%). Post-operative constipation occurred in one case (3.57%) in suture rectopexy group and occurred in one case (3.3%) in mesh rectopexy group. Fecal incontinence improved in 26/28 cases (92.8%) in suture rectopexy while in mesh rectopexy it was improved in 30/30 cases (100%) of cases. Conclusion. Both laparoscopic mesh and suture rectopexy are feasible and reliable methods for the treatment of complete rectal prolapse in children. However, no recurrence, low incidence of constipation and high improvement of incontinence at follow up more than 36 months with mesh rectopexy accordingly, we considered mesh rectopexy to be the procedure of choice in treatment of complete rectal prolapse.

scholarly journals Endoscopic techniques to reduce recurrence rates after colorectal EMR: systematic review and meta-analysis

2021 ◽  
Author(s):  
Gijs Kemper ◽  
Ayla S. Turan ◽  
Erik J. Schoon ◽  
Ruud W. M. Schrauwen ◽  
Ludger S. M. Epping ◽  
...  
Keyword(s):  
Systematic Review ◽  
Recurrence Rate ◽  
Meta Analysis ◽  
Intervention Group ◽  
Secondary Outcome ◽  
High Recurrence Rate ◽  
Complication Rates ◽  
Recurrence Rates ◽  
Soft Coagulation ◽  
Procedural Complication

Abstract Background Colorectal endoscopic mucosal resection (EMR) is an effective, safe, and minimally invasive treatment for large lateral spreading and sessile polyps. The reported high recurrence rate of approximately 20% is however one of the major drawbacks. Several endoscopic interventions have been suggested to reduce recurrence rates. We conducted a systematic review and meta-analysis to assess the efficacy of endoscopic interventions targeting the EMR margin to reduce recurrence rates. Methods We searched in PubMed and Ovid for studies comparing recurrence rates after interventions targeting the EMR margin with standard EMR. The primary outcome was the recurrence rate at the first surveillance colonoscopy (SC1) assessed histologically or macroscopically. For the meta-analysis, risk ratios (RRs) were calculated and pooled using a random effects model. The secondary outcome was post-procedural complication rates. Results Six studies with a total of 1335 lesions were included in the meta-analysis. The techniques performed in the intervention group targeting the resection margin were argon plasma coagulation, snare tip soft coagulation, extended EMR, and precutting EMR. The interventions reduced the adenoma recurrence rate with more than 50%, resulting in a pooled RR of 0.37 (95% CI 0.18, 0.76) comparing the intervention group with the control groups. Overall post-procedural complication rates did not increase significantly in the intervention arm (RR 1.30; 95% CI 0.65, 2.58). Conclusion Interventions targeting the EMR margin decrease recurrence rates and may not result in more complications.

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