Indications and outcomes of enterovesical and colovesical fistulas: systematic review of the literature and meta-analysis of prevalence

Abstract Background Entero-colovesical fistula is a rare complication of various benign and malignant diseases. The diagnosis is prominently based on clinical symptoms; imaging studies are necessary not only to confirm the presence of the fistula, but more importantly to demonstrate the extent and the nature of the fistula. There is still a lack of consensus regarding the if, when and how to repair the fistula. The aim of the study is to review the different surgical treatment options, focus on surgical indications, and explore cumulative recurrence, morbidity, and mortality rates of entero-vesical and colo-vesical fistula patients. Methods A systematic review of the literature was conducted according to PRISMA guidelines. Random effects meta-analyses of proportions were developed to assess primary and secondary endpoints. I2 statistic and Cochran’s Q test were computed to assess inter-studies’ heterogeneity. Results Twenty-two studies were included in the analysis with a total of 861 patients. Meta-analyses of proportions pointed out 5, 22.2, and 4.9% rates for recurrence, complications, and mortality respectively. A single-stage procedure was performed in 75.5% of the cases, whereas a multi-stage operation in 15.5% of patients. Palliative surgery was performed in 6.2% of the cases. In 2.3% of the cases, the surgical procedure was not specified. Simple and advanced repair of the bladder was performed in 84.3% and 15.6% of the cases respectively. Conclusions Although burdened by a non-negligible rate of complications, surgical repair of entero-colovesical fistula leads to excellent results in terms of primary healing. Our review offers opportunities for significant further research in this field. Level of Evidence Level III according to ELIS (SR/MA with up to two negative criteria).

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Using Traditional Chinese Medicine to Relieve Asthma Symptoms: A Systematic Review and Meta-Analysis

The American Journal of Chinese Medicine ◽

10.1142/s0192415x1950085x ◽

2019 ◽

Vol 47 (08) ◽

pp. 1659-1674 ◽

Cited By ~ 1

Author(s):

Mei-Hua Wang ◽

Chiehfeng Chen ◽

Mei-Ling Yeh ◽

Jaung-Geng Lin

Keyword(s):

Systematic Review ◽

Asthma Symptom ◽

Clinical Symptoms ◽

Meta Analysis ◽

Symptom Relief ◽

Governor Vessel ◽

Asthma Symptoms ◽

Bladder Meridian ◽

Conception Vessel ◽

Meta Analyses

Studies have demonstrated the effect of acupoint-based interventions in relieving the clinical symptoms of asthma. However, the effect of meridian-based interventions in asthma symptom relief is unknown. This systematic review and meta-analysis determined the effect of multiplex meridian interventions in asthma symptom relief. Eight electronic databases were searched for relevant randomized controlled trials (RCTs) that involved patients with asthma, were published before March 2018, used acupoint stimulation interventions targeting acupoints that correspond to meridians, and considered asthma symptom relief as an outcome. In 204 RCTs that were identified and used in a meta-synthesis, meridians were used 521 times, with the bladder meridian being the most frequently used. Furthermore, 23 RCTs were included in the meta-analysis. Egger’s and inconsistency tests revealed no significant differences among the studies ([Formula: see text]). However, the interventions differed significantly in terms of asthma symptom relief effect, as demonstrated by pairwise (odds ratio [Formula: see text], 95% confidence [Formula: see text]–0.37) and network ([Formula: see text], 95% credibility [Formula: see text]–0.41) meta-analyses. Surface under the cumulative ranking (SUCRA) revealed that the bladder–conception vessel–governor vessel–stomach multiplex meridian intervention was more effective than non-meridian interventions in relieving asthma symptoms. Additionally, either bladder–conception vessel–stomach or bladder–conception vessel–governor vessel–kidney multiplex meridians may be selected in interventions. This study suggests that practitioners target multiplex meridians, especially the meridians of the bladder and conception vessel, to effectively relieve asthma symptoms.

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Quilting Sutures in Rhytidectomy: A Systematic Review of the Literature

Aesthetic Surgery Journal ◽

10.1093/asj/sjz353 ◽

2019 ◽

Vol 40 (11) ◽

pp. 1157-1164 ◽

Cited By ~ 1

Author(s):

Anthony Ballan ◽

Samer Jabbour ◽

Youssef El Rayess ◽

Khalil Jabbour ◽

Lena El Hachem ◽

...

Keyword(s):

Systematic Review ◽

Relative Risk ◽

Postoperative Complications ◽

Confidence Interval ◽

Meta Analysis ◽

Control Group ◽

Published Data ◽

Review Of The Literature ◽

Level Of Evidence ◽

Safety And Efficacy

Abstract Background Different technical variations exist for the utilization of quilting sutures (QS) in rhytidectomy. No systematic review or meta-analysis of the studies describing the use of QS in facelifts has been published to date to the authors’ knowledge. Objectives The objective of this study was to summarize all the published data regarding the utilization of QS in rhytidectomy, compare QS techniques, and evaluate their effect on postoperative complications. Methods On April 1, 2019, a systematic search of the Medline, Embase, and Cochrane databases was conducted. All the studies describing the usage of QS in facelifts were included in this review. Studies reporting hematoma rate in a QS group and a control group were included in the meta-analysis part of this study. Results The initial search of the databases yielded 93 results. Four trials were included in the systematic review and 2 were included in the meta-analysis. The total number of included patients with QS was 527. Two studies employed internal QS and the remaining studies utilized external QS. The meta-analysis found a lower rate of hematoma in the QS group (relative risk, 0.02; 95% confidence interval = 0.00-0.13; P < 0.0001). Conclusions QS can be applied either internally or externally and are very effective in reducing hematomas after facelifts. QS could be a great asset in facelifts but should be utilized with caution because additional work is needed to confirm their safety and efficacy. Level of Evidence: 2

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Articular Cartilage Defects of the Glenohumeral Joint: A Systematic Review of Treatment Options and Outcomes

Cartilage ◽

10.1177/1947603519870858 ◽

2019 ◽

pp. 194760351987085 ◽

Cited By ~ 2

Author(s):

Anthony Fiegen ◽

Devin P. Leland ◽

Christopher D. Bernard ◽

Aaron J. Krych ◽

Jonathan D. Barlow ◽

...

Keyword(s):

Systematic Review ◽

Patient Reported Outcomes ◽

Glenohumeral Joint ◽

Meta Analysis ◽

Treatment Options ◽

Surgical Techniques ◽

Cartilage Defects ◽

Imaging Findings ◽

Level Of Evidence ◽

Patient Reported

Objective To report radiographic and magnetic resonance imaging findings, patient-reported outcomes, and complications and/or reoperations following nonarthroplasty surgical intervention for focal glenohumeral cartilage defects. Design A literature search was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. Patients were included if they possessed a chondral defect of the humeral head, glenoid, or both, which had been treated with a joint preserving nonarthroplasty procedure. Risk of bias assessment was performed using the Methodological Index for Non-Randomized Studies scoring system. Study demographics, surgical technique, imaging findings, patient-reported outcomes, complications, failures, and reoperations were collected. Results Fourteen studies with 98 patients (100 shoulders) met the inclusion criteria. Patient ages ranged from 7 to 74 years. The nonarthroplasty surgical techniques utilized included microfracture (67 shoulders), osteochondral transplantation (28 shoulders), chondrocyte transplantation (4 shoulders), and internal fixation (1 shoulder). The rates of radiographic union and progression of osteoarthritis ranged between 90% to 100% and 57% to 100%, respectively. Visual analog scores ranged from 0 to 1.9 at final follow-up. Mean postoperative ASES (American Shoulder and Elbow Surgeons) shoulder scores ranged from 75.8-100. Mean postoperative CSS (Constant Shoulder Score) scores ranged from 83.3-94. Mean postoperative SSV (Subjective Shoulder Value) ranged from 70% to 99%. Failure and reoperation rates ranged between 0% to 35% and 0% to 30%, respectively, with the most common reoperation being conversion to prosthetic arthroplasty. Conclusions In this systematic review, nonarthroplasty surgical techniques demonstrated acceptable rates of radiographic healing, improved patient reported outcomes, minimal complications, and low rates of failure or reoperation. Joint preserving techniques are likely viable options to prolong function of the native shoulder and provide short- to midterm pain relief in young and highly active patients. Level of Evidence Level IV.

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Clinical symptoms, comorbidities and complications features in severe and non-severe patients with COVID-19: a systematic review and meta-analysis without cases duplication

10.21203/rs.3.rs-30787/v1 ◽

2020 ◽

Author(s):

Zhufeng Wang ◽

Hongsheng Deng ◽

Changxing Ou ◽

Jingyi Liang ◽

Yingzhi Wang ◽

...

Keyword(s):

Risk Factors ◽

Systematic Review ◽

Observational Studies ◽

Fixed Effects ◽

Clinical Symptoms ◽

Meta Analysis ◽

Mortality Rates ◽

Fixed Effects Model ◽

Review Of The Literature ◽

Q Statistic

Abstract Background: The pandemic of COVID-19 posed a challenge to global healthcare. The mortality rates of severe cases range from 8.1% to 31.8%, and it is particularly important to identify risk factors that aggravate the disease.Methods: We performed a systematic review of the literature with meta-analysis, using 7 databases to assess clinical characteristics, comorbidities and complications in severe and non-severe patients with COVID-19. All the observational studies were included. We performed a random or fixed effects model meta-analysis to calculate the pooled proportion and 95% CI. Measure of heterogeneity was estimated by Cochran’s Q statistic, I2 index and P value.Results: 4881 cases from 25 studies related to COVID-19 were included. The most prevalent comorbidity was hypertension (severe: 33.4%, 95% CI: 25.4% - 41.4%; non-severe 21.6%, 95% CI: 9.9% - 33.3%), followed by diabetes (severe: 14.4%, 95% CI: 11.5% - 17.3%; non-severe: 8.5%, 95% CI: 6.1% - 11.0%). The prevalence of ARDS, AKI and shock were all higher in severe cases, with 41.1% (95% CI: 14.1% - 68.2%), 16.4% (95% CI: 3.4% - 29.5%) and 19.9% (95% CI: 5.5% - 34.4%), rather than 3.0% (95% CI: 0.6% - 5.5%), 2.2% (95% CI: 0.1% - 4.2%) and 4.1% (95% CI -4.8% - 13.1%) in non-severe patients, respectively. The death rate was higher in severe cases (30.3%, 95% CI: 13.8% - 46.8%) than non-severe cases (1.5%, 95% CI: 0.1% - 2.8%).Conclusions: Hypertension, diabetes and cardiovascular diseases may be risk factors for COVID-19 patients to develop into severe cases.

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The effectiveness of ocriplasmin versus surgery for the treatment of macular holes: A systematic review and meta-analysis

European Journal of Ophthalmology ◽

10.1177/1120672120946925 ◽

2020 ◽

pp. 112067212094692

Author(s):

Brian Edward Yu ◽

Tom Sheidow ◽

Raman-Deep Singh Sambhi ◽

Phil Hooper ◽

Monali S. Malvankar-Mehta

Keyword(s):

Systematic Review ◽

Visual Acuity ◽

Meta Analysis ◽

Treatment Options ◽

Closure Rate ◽

Randomized Controlled ◽

Macular Holes ◽

Pars Plana ◽

Meta Analyses ◽

Hole Closure

Objective: To conduct a systematic review looking at the effects of ocriplasmin compared to pars plana vitrectomy on macular holes to assess the effectiveness of the treatment options. Methods: Literature was searched through MEDLINE, EMBASE, CINAHL, Clinical Trials.gov, and ProQuest Dissertations and Theses until June 12, 2018. Conferences held through Association for Research in Vision and Ophthalmology, Canadian Society of Ophthalmology, and American Academy of Ophthalmology were searched until June 18, 2018. A total of 208 records were screened leaving 26. One author independently reviewed them for quality and extracted data. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) reporting guidelines were followed. The adverse events, MH closure rate, change in MH size, and the extent to which the patients’ visual acuity is restored by each treatment option; ocriplasmin and vitrectomy. Results: Twenty-six articles were included for qualitative and quantitative analysis. Meta-analysis results showed a 34% closure of macular holes after ocriplasmin treatment compared to 92% after vitrectomy. A significant improvement in visual acuity was seen after vitrectomy (SMD = −1.42; CI: [−1.98, −0.86]) as well as the ocriplasmin treatment (SMD = −0.73; CI: [−0.98, −0.48]). Conclusions: Results suggested 92% macular hole closure after vitrectomy compared to 34% after ocriplasmin. A significant improvement in visual acuity of patients was seen after both treatments. More good quality randomized controlled trials are required to make strong conclusions.

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Clinical manifestations in primary ciliary dyskinesia: systematic review and meta-analysis

European Respiratory Journal ◽

10.1183/13993003.00736-2016 ◽

2016 ◽

Vol 48 (4) ◽

pp. 1081-1095 ◽

Cited By ~ 69

Author(s):

Myrofora Goutaki ◽

Anna Bettina Meier ◽

Florian S. Halbeisen ◽

Jane S. Lucas ◽

Sharon D. Dell ◽

...

Keyword(s):

Systematic Review ◽

Primary Ciliary Dyskinesia ◽

Clinical Symptoms ◽

Meta Analysis ◽

Age Groups ◽

Clinical Manifestations ◽

Explanatory Factors ◽

Symptom Prevalence ◽

Meta Analyses ◽

Ciliary Dyskinesia

Few original studies have described the prevalence and severity of clinical symptoms of primary ciliary dyskinesia (PCD). This systematic review and meta-analysis aimed to identify all published studies on clinical manifestations of PCD patients, and to describe their prevalence and severity stratified by age and sex.We searched PubMed, Embase and Scopus for studies describing clinical symptoms of ≥10 patients with PCD. We performed meta-analyses and meta-regression to explain heterogeneity.We included 52 studies describing a total of 1970 patients (range 10–168 per study). We found a prevalence of 5% for congenital heart disease. For the rest of reported characteristics, we found considerable heterogeneity (I2 range 68–93.8%) when calculating the weighted mean prevalence. Even after taking into account the explanatory factors, the largest part of the between-studies variance in symptom prevalence remained unexplained for all symptoms. Sensitivity analysis including only studies with test-proven diagnosis showed similar results in prevalence and heterogeneity.Large differences in study design, selection of study populations and definition of symptoms could explain the heterogeneity in symptom prevalence. To better characterise the disease, we need larger, multicentre, multidisciplinary, prospective studies that include all age groups, use uniform diagnostics and report on all symptoms.

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Systematic review of ventricular peritoneal shunt and percutaneous endoscopic gastrostomy: a safe combination

Journal of Neurosurgery ◽

10.3171/2016.8.jns152701 ◽

2017 ◽

Vol 127 (4) ◽

pp. 899-904 ◽

Cited By ~ 10

Author(s):

Leendert H. Oterdoom ◽

D. L. Marinus Oterdoom ◽

Johannes C. F. Ket ◽

J. Marc C. van Dijk ◽

Pieter Scholten

Keyword(s):

Systematic Review ◽

Percutaneous Endoscopic Gastrostomy ◽

Meta Analysis ◽

Poor Quality ◽

Tube Placement ◽

Review Of The Literature ◽

Endoscopic Gastrostomy ◽

Peg Tube ◽

Meta Analyses ◽

Ventriculo Peritoneal Shunt

OBJECTIVEVarious international and national gastrointestinal guidelines take different positions on whether ventriculoperitoneal shunt (VPS) insertion is a contraindication to percutaneous endoscopic gastrostomy (PEG). The objective of this meta-analysis was to try to answer the question of whether VPS insertion is a contraindication to PEG.METHODSA systematic review of the literature was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria. Electronic databases PubMed and Embase were searched using variations of the terms “ventriculo-peritoneal shunt” and “percutaneous (endoscopic) gastrostomy.” This search resulted in 70 studies, 9 of which were relevant. These were cross-referenced, and 1 additional study was found, resulting in 10 studies in this systematic review.RESULTSThe 10 relevant studies in adult cohorts included 208 patients. All studies save one were retrospective and, in general, poor quality. Among the studies with relevant data, there were 26 (12.5% of 208 cases) VPS infections and 4 (4.4% of 90 cases) VPSs that malfunctioned. In 137 patients the VPS had been placed before the PEG tube, with a VPS infection rate of 4.4%. More VPS infections occurred among the 55 patients who first had a PEG and a subsequent VPS (21.8%) and in the 16 patients who had simultaneous PEG tube and VPS placement (50%). The heterogeneity of the studies in this analysis prohibited statistical comparisons of the timing of VPS and PEG tube placement.CONCLUSIONSThis systematic review indicated that VPS placement in combination with a PEG has a high but acceptable VPS complication rate. Therefore, VPS insertion should not be considered a contraindication to the placement of a PEG tube. Preferably, a PEG tube should be placed after the VPS. Waiting 7–10 days between VPS insertion and a PEG seems reasonable, but this could not be corroborated in this review.

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Therapeutics of xeroderma pigmentosum: A PRISMA-compliant systematic review

Indian Journal of Dermatology Venereology and Leprology ◽

10.25259/ijdvl_431_19 ◽

2021 ◽

Vol 0 ◽

pp. 1-14

Author(s):

Fernando Antônio Gomes de Andrade ◽

Claudio Eduardo de Oliveira Cavalcanti ◽

Felipe Contoli Isoldi ◽

Lydia Masako Ferreira

Keyword(s):

Systematic Review ◽

Xeroderma Pigmentosum ◽

Meta Analysis ◽

Scientific Evidence ◽

Treatment Options ◽

Skin Lesions ◽

Medical Subject Headings ◽

Level Of Evidence ◽

Therapeutic Modalities ◽

Surgical Treatments

Xeroderma pigmentosum is a rare hereditary autosomal recessive genodermatosis. At present, there are many treatment options for xeroderma pigmentosum, covering medical/procedural, surgical and combined modalities. However, the quality of these interventions has not been assessed. Our study aimed to perform a systematic review of the literature regarding the treatment of xeroderma pigmentosum. Multiple medical databases were accessed with the Medical Subject Headings terms; “xeroderma pigmentosum,” “therapeutics” and “surgical procedures, operative” from January 2000 to April 2019, including articles published in Portuguese, Spanish and English (PROSPERO-CRD42018114858). Two hundred and ninety-eight studies were found in the databases researched, of which, after applying the inclusion criteria, only 33 studies remained. The 33 complete articles were read by three of the authors, having been found: 16 reported medical/procedural and 17 reported surgical treatments. Only one clinical study presented a good level of evidence (EL: 2): a randomized clinical trial using a T4 endonuclease V (T4N5) liposome lotion which reduced the development of skin lesions in patients with xeroderma pigmentosum. Amongst surgical modalities, all studies presented low evidence level (EL: 4). Three illustrative cases are also presented, to emphasize the multiple number of times that surgical modalities may be required in these patients. The therapeutic modalities, both clinical and surgical, for xeroderma pigmentosum presented a low level of scientific evidence which did not allow meta-analysis. More therapeutic studies, both clinical and surgical, with better scientific evidence are needed.

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Treatment of paediatric trigger finger: a systematic review and treatment algorithm

Journal of Children s Orthopaedics ◽

10.1302/1863-2548.12.180058 ◽

2018 ◽

Vol 12 (3) ◽

pp. 209-217 ◽

Cited By ~ 3

Author(s):

M. E. Womack ◽

J. C. Ryan ◽

V. Shillingford-Cole ◽

S. Speicher ◽

G. D. Hogue

Keyword(s):

Systematic Review ◽

Treatment Options ◽

Treatment Algorithm ◽

Surgical Techniques ◽

Rare Condition ◽

Small Sample ◽

Trigger Finger ◽

Review Of The Literature ◽

Level Of Evidence ◽

Number Of Patients

Purpose Paediatric trigger finger (PTF) is a rare condition as seen by the lack of studies published about paediatric populations. Due to this general lack of information, the steps to employ to correct this disorder, whether surgically or non-surgically, have not yet reached consensus status. The objective of this study is to review the published literature regarding treatment options for PTF in order to develop a proposed step-wise treatment algorithm for children presenting with trigger finger. Methods A systematic review of the literature was conducted on PubMed to locate English language studies reporting on treatment interventions of PTF. Data was collected on number of patients/fingers seen in the study, the category of the fingers involved, the number of patients/fingers undergoing each intervention and reported outcomes. Results Seven articles reporting on 118 trigger fingers were identified. In all, 64 fingers were treated non-surgically, with 57.8% (37/64) resolving. In all, 54 fingers were initially surgically treated, with 87% (47/54) resolving. In total, 34 fingers did not have resolution of symptoms following primary treatment, and 27 fingers received follow-up treatment, with 92.6% (25/27) resolving. Overall, 92.4% (109/118) of fingers achieved resolution of symptoms after all treatments were completed. Conclusion Limitations for this study included few prospective studies and small sample sizes. This is likely due to the rarity of PTF. This review of the literature indicated that a step-wise approach, including non-operative and surgical techniques, should be employed in the management of PTF. Level of Evidence III This work meets the requirements of the PRISMA guidelines (Preferred Reporting Items for Systematic Reviews and Meta-Analyses).

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The Outcomes of Isolated Distal Realignment Procedures in Patellofemoral Instability: A Systematic Review and Meta-analysis

The Journal of Knee Surgery ◽

10.1055/s-0039-1681052 ◽

2019 ◽

Vol 33 (06) ◽

pp. 547-552

Author(s):

Si Heng Sharon Tan ◽

Sheng Yang Lim ◽

Keng Lin Wong ◽

Chintan Doshi ◽

Andrew Kean Seng Lim ◽

...

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Patellofemoral Instability ◽

Level Of Evidence ◽

Current Systematic Review ◽

Number Of Patients ◽

Proximal Realignment ◽

Number Of Publications ◽

Meta Analyses ◽

Distal Realignment

AbstractDistal realignment procedures are now commonly performed routinely with proximal realignment procedures. Despite so, only a limited number of publications exist that have looked into the efficacy of isolated distal realignment procedures, and whether there is indeed a need for routine proximal realignment procedures to be added to the distal realignment procedures. The current systematic review and meta-analysis aims to evaluate the outcomes of isolated distal realignment procedures in the management of patellofemoral instability. The review was conducted using the preferred reporting items for systematic reviews and meta-analyses (PRSIMA) guidelines. All studies that reported the outcomes of isolated distal realignment procedures for patellofemoral instability were included. A total of six publications were included, with 347 knees. All studies consistently reported a decrease in the rates of patellofemoral instability or maltracking (odds ratio [OR]: < 0.01; 95% confidence interval [CI]: < 0.01–0.01) and an increase in the odds of having a good outcome (OR: 0.01; 95% CI: < 0.01–0.02) after distal realignment procedures. A total of 24 out of 306 patients (7.8%) had postoperative instability or maltracking, and a total of 220 out of 303 patients (72.6%) were rated to have good or excellent outcomes postoperatively. Isolated distal realignment procedures can lead to good outcomes when used in the management of patellofemoral instability. These include a significantly decreased rate of patellofemoral instability or maltracking and a significantly increased number of patients with excellent or good outcomes postoperatively. Comparisons between patients with and without additional proximal realignment procedures suggest that additional proximal realignment procedures do not definitely improve the outcomes of distal realignment procedures and, therefore, should not be routinely performed in all patients undergoing distal realignment procedures. The Level of Evidence for this study is IV.

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