Partial Fundoplications (270° Toupet, 90° Dor)

2021 ◽  
pp. 263451612110217
Author(s):  
David C. Gotley ◽  
Adam J. Frankel
Keyword(s):  
Nissen Fundoplication ◽  
Controlled Trials ◽  
Partial Fundoplication ◽  
Recurrent Reflux ◽  
Randomized Controlled ◽  
Long Term Follow Up ◽  
Fundoplication Failure ◽  
Hiatal Repair

Partial fundoplication such as the Toupet posterior 270° and the Dor anterior 90° to 180° wraps were developed with the aim of providing long-term GERD control as with the successful Nissen fundoplication, but with reduced post-operative side effects such as dysphagia and gas bloat. Randomized controlled trials with long-term follow-up show this to be the case. Failure of a fundoplication occurs along a predictable anatomical course with posterior herniation almost universal. This informs our method of dissection, hiatal repair, and wrap construction using fundopexy to the diaphragm. We present the indications and our techniques for partial fundoplication, including tips on how to reduce the incidence of fundoplication failure and recurrent reflux.

scholarly journals Effects of Physical Activity on Children’s Motor Skill Development: A Systematic Review of Randomized Controlled Trials

2020 ◽  
Vol 2020 ◽  
pp. 1-14
Author(s):  
Daniel J. McDonough ◽  
Wenxi Liu ◽  
Zan Gao
Keyword(s):  
Physical Activity ◽  
Motor Skill ◽  
Skill Development ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Motor Skill Development ◽  
Long Term Follow Up ◽  
Power Analyses

Objective. This systematic review synthesized current randomized controlled trials (RCTs) examining casual evidence regarding the effects of traditional and exergaming-based physical activity (PA) interventions on motor skill development in typically developed children (i.e., those aged 6-12 years). Methods. We adhered to the PRISMA-P statement and searched electronic databases (Medline, PsycInfo, Web of Science, PubMed, ERIC, Scopus, and SportDiscus) from inception through July 2020. We screened for peer reviewed RCTs published in English between 2000 and 2020 examining the effect of PA on motor skill development in healthy children. Results. A total of 25 RCTs were included, 20 (80%) of which reported significant improvements in children’s motor skill performance. Specifically, 18 studies examined traditional PA interventions and 7 studies examined exergaming-based PA interventions, 83% and 71% of which observed statistically significant improvements in children’s motor skill development, respectively. Conclusions. Findings support the causal evidence regarding the effects of PA on motor skill development in children. Notable limitations of this review included heterogeneity of measurement protocols and assessment tools used to test children’s motor skills across studies, a wide range of PA intervention dose across studies, and the lack of power analyses and long-term follow-up assessments in individual studies to discern appropriate sample sizes and long-term effectiveness, respectively. To further strengthen the evidence in this emerging field, we advocate for future RCTs to employ a priori power analyses, long-term follow-up measurements, and more exergaming-based interventions to allow for comparisons with traditional PA interventions, to explore the dose response and moderating relationships between PA and motor skill development in childhood, and to utilize homogenous assessment instruments to allow for more rigorous, quantitative syntheses.

Quality of Randomized Controlled Trials Published By Plastic Surgeons: Long-Term Follow-Up

2019 ◽  
Vol 43 (3) ◽  
pp. 866-873
Author(s):  
Thiago Bezerra de Morais ◽  
Daniela Francescato Veiga ◽  
Joel Veiga-Filho ◽  
Andréia Cristina Feitosa do Carmo ◽  
Rosely de Fátima Pellizzon ◽  
...  
Keyword(s):  
Randomized Controlled Trials ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Long Term Follow Up

scholarly journals Minimally Invasive Surgery in Patients With Intracerebral Hemorrhage: A Meta-Analysis of Randomized Controlled Trials

2022 ◽  
Vol 12 ◽  
Author(s):  
Duanlu Hou ◽  
Ying Lu ◽  
Danhong Wu ◽  
Yuping Tang ◽  
Qiang Dong
Keyword(s):  
Minimally Invasive Surgery ◽  
Minimally Invasive ◽  
Randomized Controlled Trials ◽  
Conventional Treatment ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Long Term Follow Up

Background: Minimally invasive surgery for intracerebral hemorrhage (ICH) has been evaluated in clinical trials. Although meta-analyses on this topic have been performed in the past, recent trials have added important information to the results of the comparison. However, little work has been done to compare the effect of MIS and conventional treatment on patient prognosis, especially mortality.Methods: PubMed, EMBASE, Web of Science, Ovid, China National Knowledge Infrastructure, and ClinicalTrials.gov were searched on May 1, 2021, for randomized controlled trials of MIS for spontaneous ICH. The primary outcome was defined as death at follow-up, while the secondary outcome was defined as death in different comparisons between MIS and craniotomy (CT) or medication (Me).Results: The initial search yielded 12 high-quality randomized controlled trials involving 2,100 patients. We analyzed the odds ratios (ORs) for MIS compared with conventional treatment, including Me and conventional CT. The OR and confidence intervals (CIs) of the primary and secondary outcomes were 0.62 (0.45–0.85) for MIS vs. conventional treatment. We also conducted subgroup analyses and found that the ORs and CIs for MIS compared with that of conventional treatment in the short-term follow-up were 0.58 (0.42–0.80), and, in the long-term follow-up, was 0.67 (0.46–0.98); and found that ORs were 0.68 (0.48–0.98) for MIS vs. CT and 0.57 (0.41–0.79) for MIS vs. Me.Conclusions: This meta-analysis demonstrates that certain patients with ICH benefit in short- and long-term follow-up from MIS over other treatments, including open surgery and conventional Me.Systematic Review Registration:https://www.crd.york.ac.uk/PROSPERO/.

Validation of Microsimulation Models against Alternative Model Predictions and Long-Term Colorectal Cancer Incidence and Mortality Outcomes of Randomized Controlled Trials

2020 ◽  
Vol 40 (6) ◽  
pp. 815-829
Author(s):  
Jie-Bin Lew ◽  
Marjolein J. E. Greuter ◽  
Michael Caruana ◽  
Emily He ◽  
Joachim Worthington ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Randomized Controlled Trials ◽  
Fecal Occult Blood ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Incidence And Mortality ◽  
Long Term Follow Up ◽  
Microsimulation Models

Background. This study aimed to assess the validity of 2 microsimulation models of colorectal cancer (CRC), Policy1-Bowel and ASCCA. Methods. The model-estimated CRC risk in population subgroups with different health statuses, “dwell time” (time from incident precancerous polyp to symptomatically detected CRC), and reduction in symptomatically detected CRC incidence after a one-time complete removal of polyps and/or undetected CRC were compared with published findings from 3 well-established models ( MISCAN, CRC-SPIN, and SimCRC). Furthermore, 6 randomized controlled trials (RCTs) that provided screening using a guaiac fecal occult blood test (Funen trial, Burgundy trial, and Minnesota Colon Cancer Control Study [MCCCS]) or flexible sigmoidoscopy (NORCCAP, SCORE, and UKFSST) with long-term follow-up were simulated. Model-estimated long-term relative reductions of CRC incidence (RR inc) and mortality (RR mort) were compared with the RCTs’ findings. Results. The Policy1-Bowel and ASCCA estimates showed more similarities to CRC-SPIN and SimCRC. For example, overall dwell times estimated by Policy1-Bowel (24.0 years) and ASCCA (25.3) were comparable to CRC-SPIN (25.8) and SimCRC (25.2) but higher than MISCAN (10.6). In addition, ∼86% of Policy1-Bowel’s and ∼74% of ASCCA’s estimated RR inc and RR mort were consistent with the RCTs’ long-term follow-up findings. For example, at 17 to 18 years of follow-up, the MCCCS reported RR mort of 0.67 (95% confidence interval [CI], 0.51–0.83) and 0.79 (95% CI, 0.62–0.97) for the annual and biennial screening arm, respectively, and the UKFSST reported RR mort of 0.70 (95% CI, 0.62–0.79) for CRC at all sites and 0.54 (95% CI, 0.46–0.65) for distal CRC. The corresponding model estimates were 0.65, 0.74, 0.81, and 0.61, respectively, for Policy1-Bowel and 0.65, 0.70, 0.75, and 0.58, respectively, for ASCCA. Conclusion. Policy1-Bowel and ASCCA’s estimates are largely consistent with the data included for comparisons, which indicates good model validity.

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