scholarly journals Systematic Review and Meta-Analysis of Liver Resection for Colorectal Metastases in Elderly Patients

2018 ◽  
Vol 36 (2) ◽  
pp. 111-123 ◽  
Author(s):  
Tim van Tuil ◽  
Ali A. Dhaif ◽  
Wouter W. te Riele ◽  
Bert van Ramshorst ◽  
Hjalmar C. van Santvoort
Keyword(s):  
Systematic Review ◽  
Liver Resection ◽  
Elderly Patients ◽  
Postoperative Morbidity ◽  
Meta Analysis ◽  
Colorectal Metastases ◽  
Cochrane Library ◽  
Long Term Outcomes ◽  
Short And Long Term

Background: This systematic review and meta-analysis evaluated the short- and long-term outcomes of liver resection for colorectal liver metastases (CRLM) in elderly patients. Methods: A PubMed, EMBASE, and Cochrane Library search was performed from January 1995 to April 2017, for studies comparing both short- and long-term outcomes in younger and elderly patients undergoing liver resection for CRLM. Results: Eleven studies comparing patients aged <70 years with patients aged >70 years and 4 studies comparing patients aged <75 years with patients aged >75 years were included. Postoperative morbidity was similar in patients aged >70 years (27 vs. 30%; p = 0.35) but higher in patients aged >75 years (21 vs. 32%; p = 0.001). Postoperative mortality was higher in both patients aged >70 years (2 vs. 4%; p = 0.01) and in patients aged >75 years (1 vs. 6%; p = 0.02). Mean 5-year overall survival was lower in patients aged >70 years (40 vs. 32%; p < 0.001) but equal in patients aged >75 years (42 vs. 32%; p = 0.06). Conclusion: Although postoperative morbidity and mortality were increased with higher age, liver resection for CRLM seems justified in selected elderly patients.

Does Conversion to Open of Laparoscopically Attempted Rectal Cancer Cases Affect Short- and Long-Term Outcomes? A Systematic Review and Meta-Analysis

2018 ◽  
Vol 28 (2) ◽  
pp. 117-126 ◽  
Author(s):  
Nikolaos Gouvas ◽  
Panagiotis A. Georgiou ◽  
Christos Agalianos ◽  
Georgios Tzovaras ◽  
Paris Tekkis ◽  
...  
Keyword(s):  
Systematic Review ◽  
Rectal Cancer ◽  
Meta Analysis ◽  
Long Term Outcomes ◽  
Short And Long Term

723 TWO- VS. THREE-FIELD LYMPHADENECTOMY FOR ESOPHAGEAL CANCER. A SYSTEMATIC REVIEW AND META-ANALYSIS OF SHORT- AND LONG-TERM OUTCOMES.

2021 ◽  
Vol 34 (Supplement_1) ◽  
Author(s):  
Letícia Nogueira Datrino ◽  
Clara Lucato Santos ◽  
Guilherme Tavares ◽  
Luca Schiliró Tristão ◽  
Maria Carolina Andrade Serafim ◽  
...  
Keyword(s):  
Systematic Review ◽  
Esophageal Cancer ◽  
Meta Analysis ◽  
Operation Time ◽  
Extended Lymphadenectomy ◽  
Long Term Outcomes ◽  
Term Survival ◽  
Long Term Survival ◽  
Short And Long Term

Abstract   Nowadays, there is still no consensus about the benefits of adding neck lymphadenectomy to the traditional two-fields esophagectomy. An extended lymphadenectomy could potentially increase operation time and the risks for postoperative complications. However, extended lymphadenectomy allows resection of cervical nodes at risk for metastases, potentially increasing long-term survival rates. This study aims to estimate whether cervical prophylactic lymphadenectomy for esophageal cancer influences short- and long-term outcomes through a systematic review of literature and meta-analysis. Methods A systematic review was conducted in PubMed, Embase, Cochrane Library Central, and Lilacs (BVS). The inclusion criteria were: (1) studies that compare two-field vs. three-field esophagectomy; (2) adults (&gt;18 years); (3) articles that analyze short- or long-term outcomes; and (4) clinical trials or cohort studies. The results were summarized by forest plots, with effect size (ES) or risk difference (RD) and 95% CI. Results Twenty-five articles were selected, comprising 8,954 patients. Three-field lymphadenectomy was associated to higher operation time (ES: -1.51; 95%CI -1.84, −1.18) and higher blood loss (ES: -0.24; 95%CI: −0.37, −0.11). Also, neck lymphadenectomy inputs additional risk for pulmonary complications (RD: 0.03; 95%CI: 0.01, 0.05). No difference was noted for morbidity (RD: 0.01; 95%CI: −0.01, 0.03); leak (−0.02; 95%CI: −0.07, 0.03); postoperative mortality (RD: 0.00; 95%CI: −0.00, 0.01), and hospital stay (ES: -0.05; 95%CI -0.20, 0.10). Three-field lymphadenectomy allowed higher number of retrieved lymph nodes (MD: -1.51; 95%CI -1.84, −1.18), but did not increase the overall survival (HR: 1.11; 95%CI: 0.96, 1.26). Conclusion Prophylactic neck lymphadenectomy for esophageal cancer should be performed with caution once it is associated with poorer short-term outcomes compared to traditional two-field lymphadenectomy and does not improve long-term survival. Future esophageal cancer studies should determine the subgroup of patients who could benefit from prophylactic neck lymphadenectomy in long-term outcomes.

scholarly journals Short- and long-term outcomes after laparoscopic and open hepatic resection: systematic review and meta-analysis

HPB ◽  
2011 ◽  
Vol 13 (5) ◽  
pp. 295-308 ◽  
Author(s):  
Reza Mirnezami ◽  
Alexander H. Mirnezami ◽  
Kandiah Chandrakumaran ◽  
Mohammad Abu Hilal ◽  
Neil W. Pearce ◽  
...  
Keyword(s):  
Systematic Review ◽  
Hepatic Resection ◽  
Meta Analysis ◽  
Long Term Outcomes ◽  
Short And Long Term

scholarly journals Network Meta-Analysis Comparing the Short and Long-Term Outcomes of Alternative Access for Transcatheter Aortic Valve Replacement

2021 ◽  
Author(s):  
Sagar Ranka ◽  
Shubham Lahan ◽  
Adnan K. Chhatriwalla ◽  
Keith B. Allen ◽  
Sadhika Verma ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Transcatheter Aortic Valve Replacement ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Long Term Outcomes ◽  
Transcatheter Aortic Valve ◽  
Short And Long Term

AbstractObjectivesThis study aimed to compare short- and long-term outcomes following various alternative access routes for transcatheter aortic valve replacement (TAVR).MethodsThirty-four studies with a pooled sample size of 30,986 records were selected by searching PubMed and Cochrane library databases from inception through 11th June 2021 for patients undergoing TAVR via 1 of 6 different access sites: Transfemoral (TF), Transaortic (TAO), Transapical (TA), Transcarotid (TC), Transaxillary/Subclavian (TSA), and Transcaval (TCV). Data extracted from these studies were used to conduct a frequentist network meta-analysis with a random-effects model using TF access as a reference group.ResultsCompared with TF, both TAO [RR 1.91, 95% CI (1.46–2.50)] and TA access [RR 2.12, 95%CI (1.84–2.46)] were associated with an increased risk of 30-day mortality. No significant difference was observed for stroke, myocardial infarction, major bleeding, conversion to open surgery, and major adverse cardiovascular or cerebrovascular events in the short-term (≤ 30 days). Major vascular complications were lower in TA [RR 0.43, (95% CI, 0.28-0.67)] and TC [RR 0.51, 95% CI (0.35-0.73)] access compared to TF. The 1-year mortality was higher in the TAO [RR of 1.35, (95% CI, 1.01–1.81)] and TA [RR 1.44, (95% CI, 1.14–1.81)] groups.ConclusionNon-thoracic alternative access site utilization for TAVR implantation (TC, TSA and TCV) is associated with similar outcomes to conventional TF access. Thoracic TAVR access (TAO and TA) is associated with increased short and long-term mortality.

scholarly journals Revisional Gastric Bypass Is Inferior to Primary Gastric Bypass in Terms of Short- and Long-term Outcomes—Systematic Review and Meta-Analysis

2018 ◽  
Vol 28 (7) ◽  
pp. 2083-2091 ◽  
Author(s):  
Michał Pędziwiatr ◽  
Piotr Małczak ◽  
Mateusz Wierdak ◽  
Mateusz Rubinkiewicz ◽  
Magdalena Pisarska ◽  
...  
Keyword(s):  
Systematic Review ◽  
Gastric Bypass ◽  
Meta Analysis ◽  
Long Term Outcomes ◽  
Short And Long Term ◽  
Revisional Gastric Bypass ◽  
Primary Gastric Bypass
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