Conservative treatment versus surgery for uncomplicated appendicitis in children: a systematic review and meta-analysis

Objective This systematic review and meta-analysis evaluated the published data on the efficacy and safety of therapies for superior mesenteric venous thrombosis (SMVT), aiming to provide a reference and set of recommendations for clinical treatment. Methods Relevant databases were searched for studies published from 2000 to June 2020 on SMVT treated with conservative treatment, surgical treatment, or endovascular approach. Different treatment types were grouped for analysis and comparison, and odds ratios with corresponding 95% confidence intervals were calculated. The outcomes were pooled using meta-analytic methods and presented by forest plots. Results Eighteen articles, including eight on SMVT patients treated with endovascular therapies, were enrolled. The treatment effectiveness was compared between different groups according to the change of symptoms, the occurrence of complications, and mortality as well. The conservative treatment group had better efficacy compared to the surgery group (89.0% vs. 78.6%, P <0.05), and the one-year survival rate was also higher (94.4% vs. 80.0%, P >0.05), but without statistical significance. As for endovascular treatment, the effectiveness was significantly higher than the surgery group (94.8% vs. 75.2%, P <0.05), and the conservative treatment group as well (93.3% vs. 86.3%, P >0.05), which still requires further research for the lack of statistical significance. Conclusions Present findings indicate that anticoagulation, as conservative treatment should be the preferred clinical option in the clinic for SMVT, due to its better curative effect compared to other treatment options, including lower mortality, fewer complications, and better prognosis. Moreover, endovascular treatment is a feasible and promising approach that is worth in-depth research, for it is less invasive than surgery and has relatively better effectiveness, thus can provide an alternative option for SMVT treatment and may be considered as a reliable method in clinical.

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Surgical versus conservative treatment of unilateral subaxial non-subluxed facet fractures: A systematic review and meta-analysis

Clinical Neurology and Neurosurgery ◽

10.1016/j.clineuro.2020.106280 ◽

2020 ◽

Vol 199 ◽

pp. 106280

Author(s):

Collin J. Larkin ◽

Zachary A. Abecassis ◽

Ketan Yerneni ◽

Dominic A. Nistal ◽

Constantine L. Karras ◽

...

Keyword(s):

Systematic Review ◽

Conservative Treatment ◽

Meta Analysis

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Systematic Review and Meta-Analysis of CT Features for Differentiating Complicated and Uncomplicated Appendicitis

Radiology ◽

10.1148/radiol.2017171260 ◽

2018 ◽

Vol 287 (1) ◽

pp. 104-115 ◽

Cited By ~ 26

Author(s):

Hae Young Kim ◽

Ji Hoon Park ◽

Yoon Jin Lee ◽

Sung Soo Lee ◽

Jong-June Jeon ◽

...

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Uncomplicated Appendicitis ◽

Ct Features

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Surgical Compared with Conservative Treatment for Acute Nondisplaced or Minimally Displaced Scaphoid Fractures: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Yearbook of Hand and Upper Limb Surgery ◽

10.1016/j.yhls.2011.04.005 ◽

2011 ◽

Vol 2011 ◽

pp. 73-74

Author(s):

J.C. Elfar

Keyword(s):

Systematic Review ◽

Conservative Treatment ◽

Randomized Controlled Trials ◽

Meta Analysis ◽

Controlled Trials ◽

Randomized Controlled ◽

Scaphoid Fractures

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Efficacy of foot orthoses for the treatment of plantar heel pain: a systematic review and meta-analysis

British Journal of Sports Medicine ◽

10.1136/bjsports-2017-097892 ◽

2018 ◽

Vol 52 (16) ◽

pp. 1040-1046 ◽

Cited By ~ 13

Author(s):

Nadine Rasenberg ◽

Henrik Riel ◽

Michael S Rathleff ◽

Sita M A Bierma-Zeinstra ◽

Marienke van Middelkoop

Keyword(s):

Systematic Review ◽

Conservative Treatment ◽

Meta Analysis ◽

Heel Pain ◽

Controlled Trials ◽

Cochrane Central Register ◽

Foot Orthoses ◽

Short Term ◽

Eligibility Criteria ◽

Plantar Heel Pain

BackgroundPlantar heel pain (PHP) is common. Foot orthoses are often applied as treatment for PHP, even though there is little evidence to support this.ObjectiveTo investigate the effects of different orthoses on pain, function and self-reported recovery in patients with PHP and compare them with other conservative interventions.DesignSystematic review and meta-analysis.Data sourcesA systematic literature search was conducted in MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, Web of Science, CINAHL and Google Scholar up to January 2017.Eligibility criteria for selecting studiesRandomised controlled trials comparing foot orthoses with a control (defined as no intervention, sham or other type of conservative treatment) reporting on pain, function or self-reported recovery in patients with PHP.ResultsTwenty studies investigating eight different types of foot orthoses were included in the review. Most studies were of high quality. Pooled data from six studies showed no difference between prefabricated orthoses and sham orthoses for pain at short term (mean difference (MD) of 0.26 (95% CI −0.09 to 0.60)). No difference was found between sham orthoses and custom orthoses for pain at short term (MD 0.22 (95% CI −0.05 to 0.50)), nor was there a difference between prefabricated orthoses and custom orthoses for pain at short term (MD 0.03 (95% CI −0.15 to 0.22)). For the majority of other interventions, no significant differences were found.ConclusionsFoot orthoses are not superior for improving pain and function compared with sham or other conservative treatment in patients with PHP.PROSPERO registration numberCRD42015029659.

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Surgical versus conservative treatment of primary patellar dislocation. A systematic review and meta-analysis

International Orthopaedics ◽

10.1007/s00264-015-2856-x ◽

2015 ◽

Vol 40 (11) ◽

pp. 2277-2287 ◽

Cited By ~ 21

Author(s):

Maristella F. Saccomanno ◽

Giuseppe Sircana ◽

Mario Fodale ◽

Fabrizio Donati ◽

Giuseppe Milano

Keyword(s):

Systematic Review ◽

Conservative Treatment ◽

Patellar Dislocation ◽

Meta Analysis

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Incidence of Spontaneous Resorption of Lumbar Disc Herniation: A Meta-Analysis

January 2018 - Pain Physician ◽

10.36076/ppj.2017.1.e45 ◽

2017 ◽

Vol 1 (21;1) ◽

pp. E45-E52 ◽

Cited By ~ 2

Author(s):

Hong Jiang

Keyword(s):

Systematic Review ◽

Chinese Medicine ◽

Traditional Chinese Medicine ◽

Conservative Treatment ◽

Lumbar Disc Herniation ◽

Disc Herniation ◽

Lumbar Disc ◽

Meta Analysis ◽

Controlled Trials ◽

Randomized Controlled

Background: Lumbar disc herniation (LDH), a common disease, is often treated conservatively, frequently resulting in spontaneous resorption of the herniated disc. The incidence of this phenomenon, however, remains unknown. Objective: To analyze the incidence of spontaneous resorption after conservative treatment of LDH using computed tomography and magnetic resonance imaging. Study Design: Meta-analysis and systematic review of cohort studies. Setting: The work was performed at The Suzhou Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine. Methods: We initiated a search for the period from January 1990 to December 2015 using PubMed, Embase, and the Cochrane Library. Two independent reviewers examined the relevant reports. The references from these reports were also searched for additional trials using the criteria established in the PRISMA statement. Results: Our results represent the pooled results from 11 cohort studies. The overall incidence of spontaneous resorption after LDH was 66.66% (95% CI 51% – 69%). The incidence in the United Kingdom was 82.94% (95% CI 63.77% – 102.11%). The incidence in Japan was 62.58% (95% CI 55.71% – 69.46%). Limitations: Our study was limited because there were few sources from which to extract data, either in abstracts or published studies. There were no randomized, controlled trials that met our criteria. Conclusions: The phenomenon of LDH reabsorption is well recognized. Because its overall incidence is now 66.66% according to our results, conservative treatment may become the first choice of treatment for LDH. More large-scale, double-blinded, randomized, controlled trials are necessary to study the phenomenon of spontaneous resorption of LDH. Key words: Lumbar, disc herniation, spontaneous resorption, conservative treatment, incidence, country, meta-analysis, systematic review, observational studies, study designs

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