Safety and Postoperative Outcomes of Regional versus Global Ischemia for Partial Nephrectomy: A Systematic Review and Meta-Analysis

2014 ◽  
Vol 94 (4) ◽  
pp. 428-435 ◽  
Author(s):  
Yiduo Wang ◽  
Huan Qu ◽  
Lei Zhang ◽  
Shuqiu Chen ◽  
Bin Xu ◽  
...  
Keyword(s):  
Systematic Review ◽  
Partial Nephrectomy ◽  
Weighted Mean Difference ◽  
Meta Analysis ◽  
Global Ischemia ◽  
Current Evidence ◽  
Complication Rates ◽  
Regional Ischemia ◽  
Estimated Blood Loss ◽  
Ischemia Group

Objective: To analyze current evidence comparing the safety and outcomes of regional and global ischemia for partial nephrectomy (PN). Materials and Methods: A systematic search of the PubMed and Web of Science databases was conducted in May 2014 to identify studies comparing the safety and outcomes of regional and global ischemia for PN. A systematic review and meta-analysis was also performed. Results: Six retrospective observational studies were selected for the analysis, including 363 patients who underwent PN (162 regional ischemia and 201 global ischemia cases). Operation times were not statistically different [weighted mean difference (WMD) = 20.35 min, 95% CI: -0.28-40.97, p = 0.05], but estimated blood loss was significantly higher in the regional ischemia group (WMD = 52.04 ml, 95% CI: 14.30-89.78, p = 0.007) than in the global ischemia group. Complication rates [odds ratio (OR) = 1.16; 95% CI: 0.63-2.15, p = 0.63] and blood transfusion rates (OR = 1.85; 95% CI: 0.86-4.01, p = 0.12) of the two groups were not significantly different. The regional ischemia group showed better postoperative renal function (WMD = 4.23 ml/min, 95% CI: 2.61-5.85, p < 0.00001) than the global ischemia group, and all cases in the regional ischemia group showed negative margins. Conclusions: Regional ischemia is as safe to perform as global ischemia, and the former leads to better postoperative renal functions than the latter. These findings support the application of regional ischemia for PN.

scholarly journals Efficacy of Antimicrobial Photodynamic Therapy Compared to Nystatin Therapy in reducing Candida Colony Count in Patients with Candida-Associated Denture Stomatitis: A Systematic Review and Meta-analysis

2021 ◽  
Author(s):  
Parsa Firoozi ◽  
Nima Farshidfar ◽  
Reza Fekrazad
Keyword(s):  
Systematic Review ◽  
Photodynamic Therapy ◽  
Weighted Mean Difference ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Colony Count ◽  
Current Evidence ◽  
Antimicrobial Photodynamic Therapy ◽  
Denture Stomatitis ◽  
Assessment Development

Abstract Purpose: This meta-analysis assessed the efficacy of antimicrobial photodynamic therapy (aPDT) compared to conventional nystatin therapy (NYT) in reducing Candida colony count in patients with Candida-Associated Denture Stomatitis (CADS) and critically appraised the available literature.Methods: This meta-analysis was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) updated guidelines. A literature search was performed in four electronic databases to identify relevant articles up to 15 August 2021. Randomized controlled trials (RCTs) that assessed the efficacy of aPDT compared to NYT in reducing Candida colony count in patients with CADS were investigated. The weighted mean difference (MD) and 95% confidence interval were calculated. The I2 statistic was used to determine heterogeneity at the level of α= 0.10. The Cochrane risk of bias (RoB 2) tool was used to assess the risk of bias. Certainty of the evidence was determined using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) ranking system.Results: Only 3 eligible RCTs with 141 participants were included in this systematic review and meta-analysis. Based on the pooled results, NYT compared to aPDT, generally performed better in reducing Candida colony count (Log10 CFU/mL) in patients’ palate and patients’ denture. The included studies had a moderate risk of bias and the certainty of the evidence was low.Conclusion: Although still inconclusive, based on the current evidence aPDT may be effective in reducing Candida colony count, and treating CADS. Nonetheless, it does not appear to be more effective than conventional NYT in this regard. According to the limited number of included studies, more well-designed RCTs with larger sample sizes and standardized methodology should be conducted to validate this conclusion.

Comparison of Laparoscopic and Open Partial Nephrectomy in the Treatment of T1 Renal Tumor:a Systematic Review and Meta-analysis

2020 ◽  
Author(s):  
Yuanming Sui ◽  
Zongliang Zhang ◽  
Huaqing Sun ◽  
Kai Zhao ◽  
Zhenlin Wang ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Partial Nephrectomy ◽  
Meta Analysis ◽  
Positive Margin ◽  
Current Evidence ◽  
Surgical Approaches ◽  
Open Partial Nephrectomy ◽  
Ischemia Time ◽  
Standard Mean Difference ◽  
Estimated Blood Loss

Abstract Objective:Different surgical approaches may bring different treatment results for one disease.We thus determined to gather the current evidence to evaluate the effect of laparoscopic partial nephrecomy(LPN) and open partial nephrectomy(OPN) in the treatment of T1 renal tumor.Methods:We comprehensively researched PubMed,Embase,Google Scholar and Clinicaltrials.gov to find all referring studies(published between Jan1,2015,and Jan 1,2020 without language restrictions) .We calculated the odds ratios(OR) and standard mean difference(SMD),and analyzed their heterogeneity with RevMan 5.3 software.Results:Six studies were included finally.Comparing open partial nephrectomy, the pooled SMD of operative time was 0.14, (95% confidential index CI = [-0.11, 0.38]), the pooled SMD of estimated blood loss was -0.14, (95% CI = [-0.58, 0.31]), the pooled SMD of ischemia time was 0.57, (95% CI = [-0.02, 1.16]), the pooled SMD of length of stay was -0.55, (95% CI = [-1.12, 0.02]),and the pooled OR of positive margin was 1.02, (95% CI = [0.39, 2.68]),the pooled OR of postoperative complications was 0.74,(95% CI = [0.41, 1.36]). Conclusions:LRN had advantages on decreasing postoperative complications rate but the ischemia time of OPN was much shorter.

On-clamp versus off-clamp robotic partial nephrectomy: A systematic review and meta-analysis

2019 ◽  
Vol 86 (2) ◽  
pp. 52-62 ◽  
Author(s):  
Alessandro Antonelli ◽  
Alessandro Veccia ◽  
Simone Francavilla ◽  
Riccardo Bertolo ◽  
Pierluigi Bove ◽  
...  
Keyword(s):  
Systematic Review ◽  
Confidence Interval ◽  
Partial Nephrectomy ◽  
Weighted Mean Difference ◽  
Meta Analysis ◽  
Mean Difference ◽  
Robotic Partial Nephrectomy ◽  
Weighted Mean ◽  
Robot Assisted ◽  
Significant Difference

Background: The debate on the pros and cons of robot-assisted partial nephrectomy performed with (on-clamp) or without (off-clamp) renal artery clamping is ongoing. The aim of this meta-analysis is to summarize the available evidence on the comparative studies assessing the outcomes of these two approaches. Material and methods: A systematic review of the literature on PubMed, ScienceDirect®, and Embase® was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses Statement (PRISMA). Only comparative and case-control studies were submitted to full-text assessment and meta-analysis. RevMan 5.3 software was used. Results: From the initial retrieval of 1937 studies, 15 fulfilling inclusion criteria were selected and provided 2075 patients for analysis (702 off-clamp, 1373 on-clamp). Baseline tumor’s features showed a significant difference in size (weighted mean difference: –0.58 cm; 95% confidence interval: [–1.06, –0.10]; p = 0.02) and R.E.N.A.L. score (weighted mean difference: –0.53; 95% confidence interval: [–0.81, –0.25]; p = 0.0002), but not in the exophytic property, the location, and the PADUA score. Pooled analysis revealed shorter operative time (p = 0.02) and higher estimated blood loss (p = 0.0002) for the off-clamp group. Overall complication and transfusion rates were similar, while higher major complication rate was observed in the on-clamp approach (5.6% vs 1.9%, p = 0.03). No differences in oncological outcomes were found. Finally, functional outcomes (assessed by estimated glomerular filtration rate at early postoperative, 3 month, 6 month, and last available follow-up) were not statistically different. Conclusion: This meta-analysis shows that off-clamp robot-assisted partial nephrectomy is reserved to smaller renal masses. Under such conditions, no differences with the on-clamp approach emerged.

scholarly journals Laparoscopic Sleeve-Fundoplication for Morbidly Obese Patients with Gastroesophageal Reflux: Systematic Review and Meta-analysis

2021 ◽  
Author(s):  
Alberto Aiolfi ◽  
Giancarlo Micheletto ◽  
Jacopo Marin ◽  
Emanuele Rausa ◽  
Gianluca Bonitta ◽  
...  
Keyword(s):  
Systematic Review ◽  
Gastroesophageal Reflux ◽  
De Novo ◽  
Gastric Perforation ◽  
Meta Analysis ◽  
Reoperation Rate ◽  
Current Evidence ◽  
Morbidly Obese ◽  
Complication Rates ◽  
Long Term Effects

Abstract Introduction Laparoscopic sleeve gastrectomy (LSG) has rapidly become popular with excellent results. However, LSG may exacerbate or increase the risk of “de novo” gastroesophageal reflux disease (GERD). Adding a fundoplication has been proposed to increase the lower esophageal sphincter competency. The aim of this study was to examine the current evidence and outcomes of sleeve-fundoplication (Sleeve-F). Materials and Methods Systematic review and meta-analysis. Web of Science, PubMed, and Embase data sets were consulted. Results Six studies (485 patients) met the inclusion criteria. The age of the patient population ranged from 17 to 72 years old and 82% were females. All patients underwent sleeve-fundoplication. Rossetti, Collis-Nissen, and Nissen were the most commonly performed fundoplications. The estimated pooled prevalence of postoperative leak, gastric perforation, and overall complications were 1.0% (95% CI = 0.0–2.0%), 2.9% (95% CI = 0.0–8.3%), and 9.8% (95% CI = 6.7–13.4%), respectively. The pooled reoperation rate was 4.1% (95% CI = 1.3–10%). There was no mortality. At 12-month follow-up, the estimated pooled BMI and %EWL were 29.9 kg/m2 (95% CI = 28.5–31.2) and 66.2% (95% CI = 59.3–71.1), respectively, while esophagitis, PPI consumption, and GERD rates were 8.0% (95% CI 3–21%), 7.8% (95% CI 5–13%), and 11% (95% CI 4–26%). Conclusions This systematic review and meta-analysis shows that current evidence for Sleeve-F is limited with high postoperative gastric perforation and overall complication rates. Weight loss and GERD resolution seem promising in the short term; however, further studies are warranted to explore long-term effects with instrumental investigations. Sleeve-F should be considered cautiously while future well-structured randomized trials are warranted.

scholarly journals 1637 Ablative Therapies Versus Partial Nephrectomy for Small Renal Masses: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
V W S Chan ◽  
A Abul ◽  
H H L Ng ◽  
F H Osman ◽  
K Wang ◽  
...  
Keyword(s):  
Systematic Review ◽  
Renal Function ◽  
Propensity Score ◽  
Partial Nephrectomy ◽  
Meta Analysis ◽  
Complication Rates ◽  
Small Renal Masses ◽  
Renal Masses ◽  
Free Survival ◽  
Ablative Therapies

Abstract Introduction The optimal management of small renal masses is unclear. Ablative therapies (AT) have been advocated as a potential alternative due to lower complication rates and non-inferior oncological outcomes. We performed a systematic review to compare AT and partial nephrectomy (PN) in patients with T1aN0M0 renal masses. Method This review is registered on PROSPERO (CRD42020199099). A search was performed on Medline, EMBASE, and Cochrane CENTRAL to identify studies comparing AT and PN. Different modalities and approaches were analysed as subgroups. Outcomes include cancer-specific survival (CSS), overall survival (OS), recurrence-free survival (RFS), metastatic-free survival (MFS), postoperative complications, and change in renal function. Results From 1,351 identified records, 30 studies incorporating 85,837 patients were included for meta-analysis. Patients receiving AT were found to have significantly worse CSS, OS, RFS when compared to patients receiving PN (p &lt; 0.05). Patients undergoing AT have a non-inferior MFS and significantly fewer overall complications (HR: 0.79, 95% CI 0.41-1.51, p = 0.48; RR: 0.71, 95% CI 0.53-0.96, p = 0.03). Patients undergoing AT have a smaller decline in renal function post-operatively (SMD: 0.30, 95% CI 0.11-0.50). When limited to studies with propensity score matching, CSS and RFS are no longer significantly different between the two groups (HR: 1.54, 95% CI 0.67-3.52, p = 0.31, HR: 1.72, 95% CI 0.90-3.28, p = 0.10). Subgroup analyses did not show significant differences between different modalities and approaches of AT in all outcomes. Conclusions AT is potentially non-inferior to PN when managing small renal masses, and more high-quality propensity score-matched studies with long follow-up time are needed to confirm the non-inferiority.

The association between dietary inflammatory index and risk of central obesity in adults: An updated systematic review and meta-analysis

2020 ◽  
Vol 90 (5-6) ◽  
pp. 535-552 ◽  
Author(s):  
Mahdieh Abbasalizad Farhangi ◽  
Mahdi Vajdi
Keyword(s):  
Systematic Review ◽  
Observational Studies ◽  
Central Obesity ◽  
Assessment Tool ◽  
Weighted Mean Difference ◽  
Meta Analysis ◽  
Dietary Factors ◽  
Cross Sectional ◽  
Inflammatory Status ◽  
Obesity Indices

Abstract. Backgrounds: Central obesity, as a pivotal component of metabolic syndrome is associated with numerous co-morbidities. Dietary factors influence central obesity by increased inflammatory status. However, recent studies didn’t evaluate the association between central obesity and dietary inflammation index (DII®) that give score to dietary factors according to their inflammatory potential. In the current systematic review and meta-analysis, we summarized the studies that investigated the association between DII® with central obesity indices in the general populations. Methods: In a systematic search from PubMed, SCOPUS, Web of Sciences and Cochrane electronic databases, we collected relevant studies written in English and published until 30 October 2019. The population of included studies were apparently healthy subjects or individuals with obesity or obesity-related diseases. Observational studies that evaluated the association between DII® and indices of central obesity including WC or WHR were included. Results: Totally thirty-two studies were included; thirty studies were cross-sectional and two were cohort studies with 103071 participants. Meta-analysis of observational studies showed that higher DII® scores were associated with 1.81 cm increase in WC (Pooled weighted mean difference (WMD) = 1.813; CI: 0.785–2.841; p = 0.001). Also, a non-significant increase in the odds of having higher WC (OR = 1.162; CI: 0.95–1.43; p = 0.154) in the highest DII category was also observed. In subgroup analysis, the continent, dietary assessment tool and gender were the heterogeneity sources. Conclusion: The findings proposed that adherence to diets with high DII® scores was associated with increased WC. Further studies with interventional designs are necessary to elucidate the causality inference between DII® and central obesity indices.

Prevalence of Benign Pathology after Partial Nephrectomy for Suspected Renal Tumor: A Systematic Review and Meta-Analysis

2019 ◽  
Author(s):  
Jae Heon Kim ◽  
Sung Ryul Shim ◽  
Hyun Young Lee ◽  
Jae Joon Park ◽  
Yash Khandwala ◽  
...  
Keyword(s):  
Systematic Review ◽  
Partial Nephrectomy ◽  
Renal Tumor ◽  
Meta Analysis ◽  
Benign Pathology

Puerarin for OVX-Induced Postmenopausal Osteoporosis in Murine Model: Systematic Review and Meta-Analysis

2020 ◽  
Vol 15 (1) ◽  
pp. 37-42 ◽  
Author(s):  
Xiaobin Yang ◽  
Haishi Zheng ◽  
Yuan Liu ◽  
Dingjun Hao ◽  
Baorong He ◽  
...  
Keyword(s):  
Systematic Review ◽  
Bone Mass ◽  
Postmenopausal Osteoporosis ◽  
Murine Model ◽  
Weighted Mean Difference ◽  
Meta Analysis ◽  
Mean Difference ◽  
Weighted Mean ◽  
Enhancing Effect ◽  
Searching Strategy

Aims/Background: Ovariectomy (OVX)-induced murine model is widely used for postmenopausal osteoporosis study. Our current study was conducted to systematically review and essentially quantified the bone mass enhancing effect of puerarin on treating OVX-induced postmenopausal osteoporosis in murine model. Methods: Literatures from PUBMED, EMBASE, and CNKI were involved in our searching strategy by limited the inception date to January 9th, 2019. Moreover, the enhancing effect of puerarin on bone mass compared to OVX-induced rats is evaluated by four independent reviewers. Finally, all the data were extracted, quantified and analyzed via RevMan, besides that in our current review study, we assessed the methodological quality for each involved study. Results: Based on the searching strategy, eight randomization studies were finally included in current meta-analysis and systematic review. According to the data analysis by RevMan, puerarin could improve bone mineral density (BMD); (eight studies, n=203; weighted mean difference, 0.05; 95% CI, 0.03-0.07; P<0.0001) using a random-effects model. There is no significant difference between puerarin and estrogen (seven studies, n=184; weighted mean difference, 0.00; 95% CI, -0.01 to 0.00; P=0.30). Conclusions: Puerarin showed upregulating effects on bone mass in OVX-induced postmenopausal osteoporosis in murine model. More studies of the effect of puerarin on bone density in OVX animals are needed.

scholarly journals The Prevalence of Sarcopenia and Its Impact on Clinical Outcomes in Lumbar Degenerative Spine Disease—A Systematic Review and Meta-Analysis

2021 ◽  
Vol 10 (4) ◽  
pp. 773
Author(s):  
Wei-Ting Wu ◽  
Tsung-Min Lee ◽  
Der-Sheng Han ◽  
Ke-Vin Chang
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Clinical Outcomes ◽  
Meta Analysis ◽  
Clinical Manifestations ◽  
Current Evidence ◽  
Degenerative Spine ◽  
Degenerative Spine Disease ◽  
Spine Disease

The association of sarcopenia with poor clinical outcomes has been identified in various medical conditions, although there is a lack of quantitative analysis to validate the influence of sarcopenia on patients with lumbar degenerative spine disease (LDSD) from the available literature. Therefore, this systematic review and meta-analysis aimed to summarize the prevalence of sarcopenia in patients with LDSD and examine its impact on clinical outcomes. The electronic databases (PubMed and Embase) were systematically searched from inception through December 2020 for clinical studies investigating the association of sarcopenia with clinical outcomes in patients with LDSD. A random-effects model meta-analysis was carried out for data synthesis. This meta-analysis included 14 studies, comprising 1953 participants. The overall prevalence of sarcopenia among patients with LDSD was 24.8% (95% confidence interval [CI], 17.3%–34.3%). The relative risk of sarcopenia was not significantly increased in patients with LDSD compared with controls (risk ratio, 1.605; 95% CI, 0.321–8.022). The patients with sarcopenia did not experience an increase in low back and leg pain. However, lower quality of life (SMD, −0.627; 95% CI, −0.844–−0.410) were identified postoperatively. Sarcopenia did not lead to an elevated rate of complications after lumbar surgeries. Sarcopenia accounts for approximately one-quarter of the population with LDSD. The clinical manifestations are less influenced by sarcopenia, whereas sarcopenia is associated with poorer quality of life after lumbar surgeries. The current evidence is still insufficient to support sarcopenia as a predictor of postoperative complications.

scholarly journals Complications of Outpatient and Inpatient Renal Biopsy: A Systematic Review and Meta-Analysis

Diagnostics ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. 651
Author(s):  
Shih-Yi Lin ◽  
Cherry Yin-Yi Chang ◽  
Cheng-Chieh Lin ◽  
Wu-Huei Hsu ◽  
I.-Wen Liu ◽  
...  
Keyword(s):  
Systematic Review ◽  
Renal Biopsy ◽  
Meta Analysis ◽  
Random Effect ◽  
Bleeding Risk ◽  
Complication Rates ◽  
Bleeding Events ◽  
Cochrane Database ◽  
Renal Biopsies ◽  
Inpatient Settings

Background: The evidence indicates that the optimal observation period following renal biopsy ranges between 6 and 8 h. This systematic review and meta-analysis explored whether differences exist in the complication rates of renal biopsies performed in outpatient and inpatient settings. Methods: We searched the MEDLINE, EMBASE, and the Cochrane Database of Systematic Reviews from 1985 to February 2020. Two reviewers independently selected studies evaluating the bleeding risk from renal biopsies performed in outpatient and inpatient settings and reviewed their full texts. The primary and secondary outcomes were risks of bleeding and major events (including mortality) following the procedure, respectively. Subgroup analysis was conducted according to the original study design (i.e., prospective or retrospective). Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using a random effect meta-analysis. Heterogeneity was assessed using the I2 test. Results: Data from all 10 eligible studies, which included a total of 1801 patients and 203 bleeding events, were included for analysis. Renal biopsies in outpatient settings were not associated with a higher bleeding risk than those in inpatient settings (OR = 0.81; 95% CI, 0.59–1.11; I2 = 0%). The risk of major events was also comparable across both groups (OR = 0.45; 95% CI, 0.16–1.29; I2 = 4%). Conclusions: Similar rates of bleeding and major events following renal biopsy in outpatient and inpatient settings were observed.

Sign in / Sign up

Export Citation Format

Share Document