Minimally Invasive versus Open Simultaneous Resections of Colorectal Cancer and Synchronous Liver Metastases: A Meta-Analysis

2018 ◽  
Vol 84 (2) ◽  
pp. 192-200 ◽  
Author(s):  
Yulin Guo ◽  
Yunhe Gao ◽  
Guijin Chen ◽  
Chen Li ◽  
Guanglong Dong
Keyword(s):  
Colorectal Cancer ◽  
Blood Loss ◽  
Confidence Interval ◽  
Minimally Invasive ◽  
Liver Metastases ◽  
Meta Analysis ◽  
Mean Difference ◽  
Cochrane Library ◽  
Postoperative Stay ◽  
Surgical Blood Loss

The aim of this meta-analysis was to compare the efficacy and safety of simultaneous resections between the minimally invasive approach (MIA) and the open approach (OA) for patients with colorectal cancer (CRC) and synchronous colorectal liver metastases (SCRLM). A systematic search was conducted in the Cochrane Library, PubMed, EMBASE and Ovid databases (until May 5, 2016). Studies comparing the perioperative results and long-term outcomes for patients undergoing simultaneous CRC and SCRLM resections between the two approaches were evaluated. Six studies were identified, which included 164 minimally invasive and 213 open simultaneous resections of CRC and SCRLM. MIA was associated with lesser surgical blood loss (mean difference = -155.85 mL; 95% confidence interval: -305.64 to -6.06, P = 0.04) and shorter length of postoperative stay (mean difference = -3.16 days; 95% confidence interval: -4.00 to -2.31, P < 0.00001.). The other perioperative results, including operating time, operative blood transfusion, intestinal function recovery time, and postoperative complications, did not differ significantly. No significant difference in the disease-free survival and overall survival rates between the two approaches was observed. In conclusion, compared with the OA, the MIA for simultaneous CRC and SCRLM resections is safe and effective for the treatment of SCRLM with lesser surgical blood loss and shorter length of postoperative stay. The MIA may be an alternative to the OA for simultaneous CRC and SCRLM resections for appropriately selected patients with resectable SCRLM.

scholarly journals Perioperative morbidity of different operative approaches in early cervical carcinoma: a systematic review and meta-analysis comparing minimally invasive versus open radical hysterectomy

2021 ◽  
Author(s):  
J. Kampers ◽  
E. Gerhardt ◽  
P. Sibbertsen ◽  
T. Flock ◽  
H. Hertel ◽  
...  
Keyword(s):  
Blood Loss ◽  
Minimally Invasive ◽  
Hospital Stay ◽  
Radical Hysterectomy ◽  
Postoperative Morbidity ◽  
Meta Analysis ◽  
Operation Time ◽  
Mean Difference ◽  
Inclusion Criteria ◽  
Estimated Blood Loss

Abstract Purpose Radical hysterectomy and pelvic lymphadenectomy is the standard treatment for early cervical cancer. Studies have shown superior oncological outcome for open versus minimal invasive surgery, but peri- and postoperative complication rates were shown vice versa. This meta-analysis evaluates the peri- and postoperative morbidities and complications of robotic and laparoscopic radical hysterectomy compared to open surgery. Methods Embase and Ovid-Medline databases were systematically searched in June 2020 for studies comparing robotic, laparoscopic and open radical hysterectomy. There was no limitation in publication year. Inclusion criteria were set analogue to the LACC trial. Subgroup analyses were performed regarding the operative technique, the study design and the date of publication for the endpoints intra- and postoperative morbidity, estimated blood loss, hospital stay and operation time. Results 27 studies fulfilled the inclusion criteria. Five prospective, randomized-control trials were included. Meta-analysis showed no significant difference between robotic radical hysterectomy (RH) and laparoscopic hysterectomy (LH) concerning intra- and perioperative complications. Operation time was longer in both RH (mean difference 44.79 min [95% CI 38.16; 51.42]), and LH (mean difference 20.96 min; [95% CI − 1.30; 43.22]) than in open hysterectomy (AH) but did not lead to a rise of intra- and postoperative complications. Intraoperative morbidity was lower in LH than in AH (RR 0.90 [0.80; 1.02]) as well as in RH compared to AH (0.54 [0.33; 0.88]). Intraoperative morbidity showed no difference between LH and RH (RR 1.29 [0.23; 7.29]). Postoperative morbidity was not different in any approach. Estimated blood loss was lower in both LH (mean difference − 114.34 [− 122.97; − 105.71]) and RH (mean difference − 287.14 [− 392.99; − 181.28]) compared to AH, respectively. Duration of hospital stay was shorter for LH (mean difference − 3.06 [− 3.28; − 2.83]) and RH (mean difference − 3.77 [− 5.10; − 2.44]) compared to AH. Conclusion Minimally invasive radical hysterectomy appears to be associated with reduced intraoperative morbidity and blood loss and improved reconvalescence after surgery. Besides oncological and surgical factors these results should be considered when counseling patients for radical hysterectomy and underscore the need for new randomized trials.

scholarly journals Influence of reminder therapy for controlling bacterial plaque in patients undergoing orthodontic treatment: A systematic review and meta-analysis

2018 ◽  
Vol 88 (4) ◽  
pp. 483-493 ◽  
Author(s):  
Igor Felipe Pereira Lima ◽  
Walbert de Andrade Vieira ◽  
Ítalo de Macedo Bernardino ◽  
Pedro Augusto Costa ◽  
Anderson Paulo Barbosa Lima ◽  
...  
Keyword(s):  
Confidence Interval ◽  
Orthodontic Treatment ◽  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
Mean Difference ◽  
Plaque Index ◽  
Cochrane Library ◽  
Gingival Index ◽  
White Spots ◽  
Standardized Mean Difference

ABSTRACT Objective: To assess the scientific evidence regarding the influence of reminder therapy on plaque index, gingival index, and white spots in patients subjected to orthodontic treatment. Materials and Methods: Randomized clinical trials were searched in the electronic databases LILACS, PubMed, SciELO, Scopus, Web of Science, Embase, LIVIVO, and Cochrane Library. The databases OpenThesis and OpenGrey were used to capture the “gray literature,” preventing selection and publication biases. The risk of bias was assessed by the Joanna Briggs Institute Critical Appraisal Checklist for Randomized Controlled Trials tool. The software Review Manager was used for the meta-analysis. The heterogeneity among studies was assessed through the I2 statistic. A summary of the overall strength of evidence available was assessed using the Grades of Recommendations Assessment, Development, and Evaluation tool. Results: A total of 332 records were found, from which only 7 articles met the inclusion criteria and were subjected to analysis. Reminder therapy showed improved scores for the plaque index (standardized mean difference = −1.22; 95% confidence interval = −2.03 to −0.42; P = .003) and the gingival index (standardized mean difference = 1.49; 95% confidence interval = −2.61 to 0.37; P = .009). Moreover, there was lower occurrence of white spots (relative risk = 0.53; 95% confidence interval = 0.38 to 0.74; P &lt; .001) when reminder therapy was implemented. Conclusions: According to the existing high-quality evidence, reminder therapy is a valuable strategy and may contribute to the reduction of plaque and gingival indices as well as to the lower occurrence of white spots in patients subjected to orthodontic treatment.

scholarly journals Epicardial Adipose Tissue in Patients with Obstructive Sleep Apnea: A Systematic Review and Meta-analysis

2020 ◽  
Vol 5 (2) ◽  
pp. 81-88
Author(s):  
Bin Liu ◽  
Yingrui Li ◽  
Jianlin Du ◽  
Qiang She ◽  
Songbai Deng
Keyword(s):  
Obstructive Sleep Apnea ◽  
Adipose Tissue ◽  
Sleep Apnea ◽  
Confidence Interval ◽  
Epicardial Adipose Tissue ◽  
Meta Analysis ◽  
Mean Difference ◽  
Cochrane Library ◽  
Obstructive Sleep ◽  
Standardized Mean Difference

Objective: Epicardial adipose tissue (EAT) is a potential risk factor for obstructive sleep apnea (OSA). We performed a meta-analysis to assess the association of EAT with OSA.Methods: The PubMed, EMBASE, Web of Science, Cochrane Library, and Wanfang databases were searched by two independent investigators for all observational studies assessing the association of EAT with OSA. Then we assessed the association of EAT thickness (EAT-t) and EAT volume (EAT-v) with OSA by a meta-analysis.Results: Ten studies were included in the final analysis. Compared with that in controls, EAT-t in OSA patients was significantly increased (standardized mean difference 0.88, 95% confidence interval 0.72‐1.05, P=0.000). Furthermore, EAT-t was greater in OSA patients than in controls with similar BMIs. However, we did not find significant differences in EAT-v between OSA patients and controls (standardized mean difference 2.46, 95% confidence interval −0.36 to 5.29, P=0.088). EAT-t in the mild, moderate, and severe OSA subgroups was greater than in the controls. In addition, there were significant differences in EAT-t among the mild, moderate, and severe OSA subgroups.Conclusions: EAT-t was greater in patients with OSA than in controls, and EAT-t was also associated with the severity of OSA. These findings may provide a new clue for the pathogenesis and treatment of OSA.

The efficacy and safety of intravaginal oxytocin on vaginal atrophy: A systematic review

2020 ◽  
pp. 205336912094664
Author(s):  
Zahra Ghorbani ◽  
Mojgan Mirghafourvand
Keyword(s):  
Systematic Review ◽  
Confidence Interval ◽  
Fixed Effects ◽  
Meta Analysis ◽  
Mean Difference ◽  
Cochrane Library ◽  
Vaginal Atrophy ◽  
Suitable Alternative ◽  
Statistical Heterogeneity ◽  
Standardized Mean Difference

Genitourinary syndrome of menopause is a major issue in menopausal health. Because unlike vasomotor symptoms, it has a progressive trend. In this regard we conducted a systematic review to evaluate the efficacy of intravaginal oxytocin on postmenopausal vaginal atrophy. A search was performed for published studies in Cochrane Library, MEDLINE, Web of Science, Embase, Scopus, ProQuest, Google Scholar and Persian databases without time and language limitations. Only randomized controlled trials that compared intravaginal oxytocin with placebos were included. The outcome measures were objective and subjective assessed symptoms of vaginal atrophy. Statistical heterogeneity was evaluated using the I2. The standardized mean differences were pooled the fixed effects model. Of the five included studies, four studies meta-analysed. The meta-analysis in terms of the cytological analysis (standardized mean difference: 35.13, 95% confidence interval: 32.59–37.67, n = 218, I2 = 96%) was statistically significant. In terms of histological assessments (standardized mean difference: −0.38, 95% confidence interval: −0.94 to 0.17, n = 38, I2 = 0%) and endometrial thickness (standardized mean difference: 0.05, 95% confidence interval: −0.20 to −0.31, n = 95, I2 = 0%), there were no statistically significant differences between the groups. Three studies reported a statistically significant improvement in the subjective symptoms; however, we were unable to perform a meta-analysis. Four of the included studies assessed side effects, but only two studies reported them. Oxytocin as a nonestrogenic compound can be a suitable alternative for the treatment of vaginal atrophy, especially in women with contraindications for using estrogenic compounds. Further good quality clinical trials with long-term follow-ups are recommended to demonstrate the effects of intravaginal gel in the treatment of vaginal atrophy.

scholarly journals Laparoscopic procedure is associated with lower morbidity for simultaneous resection of colorectal cancer and liver metastases: an updated meta-analysis

2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Long Pan ◽  
Chenhao Tong ◽  
Siyuan Fu ◽  
Jing Fang ◽  
Qiuxia Gu ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Laparoscopic Surgery ◽  
Postoperative Complications ◽  
Blood Loss ◽  
Meta Analysis ◽  
Effective Length ◽  
Cochrane Library ◽  
Intraoperative Blood Loss ◽  
Surgery Group ◽  
Simultaneous Resection

Abstract Background It has been demonstrated that simultaneous resection of both primary colorectal lesion and metastatic hepatic lesion is a safe approach with low mortality and postoperative complication rates. However, there are some controversies over which kind of surgical approach is better. The aim of study was to compare the efficacy and safety of laparoscopic surgeries and open surgeries for simultaneous resection of colorectal cancer (CRC) and synchronous colorectal liver metastasis (SCRLM). Methods A systemic search of online database including PubMed, Web of Science, Cochrane Library, and Embase was performed until June 5, 2019. Intraoperative complications, postoperative complications, and long-term outcomes were synthesized by using STATA, version 15.0. Cumulative and single-arm meta-analyses were also conducted. Results It contained twelve studies with 616 patients (273 vs 343, laparoscopic surgery group and open surgery group, respectively) and manifested latest surgical results for the treatment of CRC and SCRLM. Among patients who underwent laparoscopic surgeries, they had lower rates of postoperative complications (OR = 0.66, 95% CI: 0.46 to 0.96, P = 0.028), less intraoperative blood loss (weight mean difference (WMD) = − 113.31, 95% CI: − 189.03 to − 37.59, P = 0.003), less time in the hospital and recovering after surgeries (WMD = − 2.70, 95% CI: − 3.99 to − 1.40, P = 0.000; WMD = − 3.20, 95% CI: − 5.06 to − 1.34, P = 0.001), but more operating time (WMD = 36.57, 95% CI: 7.80 to 65.35, P = 0.013). Additionally, there were no statistical significance between two kinds of surgical approaches in disease-free survival and overall survival. Moreover, cumulative meta-analysis indicated statistical difference in favor of laparoscopic surgery in terms of morbidity was firstly detected in the 12th study in 2018 (OR = 0.66, 95% CI: 0.46 to 0.96, P = 0.028) as the 95% CI narrowed. Conclusion Compared with open surgeries, laparoscopic surgeries are safer (postoperative complications and intraoperative blood loss) and more effective (length of hospital stay and postoperative stay), and it can be considered as the first option for management of SCRLM in high-volume laparoscopic centers. Trial registration CRD42020151176

scholarly journals Effect of Spirulina Supplementation on Systolic and Diastolic Blood Pressure: Systematic Review and Meta-Analysis of Randomized Controlled Trials

Nutrients ◽  
2021 ◽  
Vol 13 (9) ◽  
pp. 3054
Author(s):  
Piotr Machowiec ◽  
Gabriela Ręka ◽  
Marcela Maksymowicz ◽  
Halina Piecewicz-Szczęsna ◽  
Agata Smoleń
Keyword(s):  
Blood Pressure ◽  
Confidence Interval ◽  
Randomized Controlled Trials ◽  
Diastolic Blood Pressure ◽  
Meta Analysis ◽  
Mean Difference ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Significant Lowering ◽  
Randomized Controlled

Spirulina is a microalga that presents various important pro-health properties, for instance lowering blood pressure in the research. The study aims to appraise the efficacy of Spirulina administration on systolic (SBP) and diastolic blood pressure (DBP). Randomized controlled trials (RCTs) were retrieved by a systematic search of PubMed, Web of Science, and the Cochrane Library databases from inception to June 2021 according to a standardized protocol. The effect size of each study was counted from mean and standard deviation before and after the intervention and shown as Un-standardized mean difference and 95% confidence interval. Sensitivity analyses were performed. Meta-analysis on 5 RCTs with 230 subjects was eligible. The amount of Spirulina ranged from 1 to 8 g per day, and intervention durations ranged from 2 to 12 weeks. Data analysis indicated that Spirulina supplementation led to a significant lowering of SBP (Mean Difference (MD): −4.59 mmHg, 95% Confidence Interval (CI): −8.20 to −0.99, I square statistic (I2) = 65%) and significant lowering of DBP (MD: −7.02 mmHg, CI: −8.86 to −5.18, I2 = 11%), particularly in a subgroup of hypertensive patients. Spirulina administration might have a supportive effect on the prevention and treatment of hypertension. More exact randomized controlled trials are needed to clarify the effect of Spirulina supplementation on blood pressure.

scholarly journals The effect of auricular therapy on blood pressure: A systematic review and meta-analysis

2019 ◽  
Vol 19 (1) ◽  
pp. 20-30 ◽  
Author(s):  
JiaLiang Gao ◽  
Guang Chen ◽  
HaoQiang He ◽  
Chao Liu ◽  
QingYong He ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Confidence Interval ◽  
Antihypertensive Drugs ◽  
Meta Analysis ◽  
Scientific Journal ◽  
Mean Difference ◽  
Cochrane Library ◽  
Efficacy Rate ◽  
Post Intervention ◽  
Auricular Therapy

Background: Although a number of clinical studies have investigated the effectiveness and safety of auricular therapy for treating hypertension, the overall evidence remains uncertain. Aims: We aimed to evaluate the evidence for the effect of auricular therapy on blood pressure using meta-analysis methodology. Methods: We searched PubMed, Embase, Cochrane Library databases, Clinicalkey, China National Knowledge Infrastructure, China Scientific Journal Database and Wanfang Database and Chinese Biomedicine for trials that compared the effects of auricular therapy to that of sham auricular therapy, antihypertensive drugs, or no intervention on blood pressure. Blood pressure values before and after treatment, magnitude of blood pressure change between baseline and post-intervention, and the efficacy rate, as outcomes, were synthesized by RevMan 5.3. Continuous outcomes were expressed as weighted mean differences, and dichotomous data were expressed as relative risks with 95% confidence intervals. Results: We systematically reviewed 44 randomized controlled trials (involving 5022 patients through June 2018). Auricular acupressure plus antihypertensive drugs might be more effective than antihypertensive drugs alone in both reducing systolic blood pressure value after treatment ( n=464 patients; mean difference, −5.06 mm Hg; 95% confidence interval, –6.76– −3.36, p<0.00001; I2=32%), decreasing diastolic blood pressure after treatment ( n=464 patients; mean difference, −5.30 mm Hg; 95% confidence interval, –6.27– −4.33, p<0.00001; I2=0%) and the efficacy rate (relative risk, 1.22; 95% confidence interval, 1.17–1.26; p<0.00001; I2=0%). Conclusion: Auricular therapy could be provided to patients with hypertension as an adjunct to antihypertensive drugs for lowering blood pressure value and achieving blood pressure targets.

Home-Based Phototherapy Versus Hospital-Based Phototherapy for Treatment of Neonatal Hyperbilirubinemia: A Systematic Review and Meta-Analysis

2020 ◽  
Vol 59 (6) ◽  
pp. 588-595 ◽  
Author(s):  
Liangliang Chu ◽  
Jianhong Qiao ◽  
Cuiping Xu
Keyword(s):  
Confidence Interval ◽  
Meta Analysis ◽  
Mean Difference ◽  
Neonatal Hyperbilirubinemia ◽  
Cochrane Library ◽  
Total Serum ◽  
Standard Mean Difference ◽  
Home Based ◽  
Significant Difference ◽  
The Comparative Study

Objective. Phototherapy devices have been found to be an effective method for treating neonatal hyperbilirubinemia. We reviewed the current literature to determine whether home-based phototherapy is more effective than hospital-based phototherapy for the treatment of neonatal hyperbilirubinemia. Method. PubMed, Scopus, Embase, Cochrane library, CBM, CNKI, and Wanfang Data were searched to collect the comparative study of home-based phototherapy versus hospital-based phototherapy for the treatment of neonatal hyperbilirubinemia. All studies were found to be of low risk based on Cochrane Collaborative Risk of Bias Tool. Data were statistically extracted and evaluated by RevMan 5.3 software. Result. A total of 259 neonates were included in the meta-analysis. Compared with hospital-based phototherapy, home-based phototherapy appeared more effective for the treatment of neonatal hyperbilirubinemia in reducing the rate of total serum bilirubin (standard mean difference = 0.32, 95% confidence interval = −0.22 to 0.86, P = .04); however, there was no significant difference in duration of phototherapy (standard mean difference = 0.59, 95% confidence interval = 0.28 to 0.90, P = .06) in the 2 groups. Conclusion. Home-based phototherapy was more effective than hospital-based phototherapy in treatment for neonatal hyperbilirubinemia; home-based phototherapy is an effective, feasible, safe, and alternative to hospital-based phototherapy for neonatal hyperbilirubinemia.

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