LigaSure small jaw versus conventional neck dissection: a systematic review and meta-analysis

Abstract Background Neck dissection has a central role in the management of head and neck cancers. This systematic review aimed to compare the intraoperative and postoperative parameters between conventional and LigaSure Small Jaw (LSJ)-assisted neck dissection. Methods PubMed (MEDLINE), Embase, and the Cochrane Library were searched. independently by two authors for relevant articles comparing the outcomes of conventional and LSJ-assisted neck dissection. Data from each study were extracted, and a random-effects model was used in the pooled analysis. Results Compared with conventional techniques, LSJ-assisted neck dissection was associated with a significantly reduced operative time. The rates of postoperative hematoma, infection, amount of intraoperative blood loss, the length of hospital stay and the drainage amount showed no significant intergroup differences. Conclusions The meta-analysis provides evidence that properly using LSJ may reduce the operative time compared with that of conventional techniques. Surgeons may consider using LSJ in neck dissection according to personal experiences. Graphical abstract

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Direct anterior versus posterolateral approaches for clinical outcomes after total hip arthroplasty: a systematic review and meta-analysis

Journal of Orthopaedic Surgery and Research ◽

10.1186/s13018-020-01747-x ◽

2020 ◽

Vol 15 (1) ◽

Cited By ~ 1

Author(s):

Wang Chen ◽

Jian-Ning Sun ◽

Ye Zhang ◽

Yu Zhang ◽

Xiang-Yang Chen ◽

...

Keyword(s):

Systematic Review ◽

Blood Loss ◽

Operative Time ◽

Weighted Mean Difference ◽

Meta Analysis ◽

Length Of Hospital Stay ◽

Operation Time ◽

Direct Anterior Approach ◽

Harris Hip Score ◽

Cochrane Library

Abstract Objective The main objective of our study was to compare the intraoperative and postoperative outcomes of direct anterior approach (DAA) with posterolateral approaches (PLA). Methods We searched Cochrane library, Web of Science, and PubMed for literatures comparing DAA with PLA. On the basis of inclusion and exclusion criteria, relevant literatures were selected. Two members independently screened qualified literatures, evaluated the literature quality, and extracted data information. Results Eighteen randomized controlled trials (RCTs) and non-RCTs totaling 34,873 patients (DAA = 9636, PLA = 25237) were contained in this systematic review and meta-analysis. The results showed that DAA were reduced in terms of length of hospital stay (weighted mean difference (WMD) = −0.43, 95% confidence interval (CI) −0.78 to −0.09, P = 0.01), LLD (WMD = −2.00, 95% CI −2.75 to −1.25, P < 0.00001), PE/DVT (WMD = 0.36, 95% CI 0.15 to 0.85, P = 0.02), dislocation (WMD = 0.42, 95% CI 0.30 to 0.59, P < 0.00001) and visual analog scale (VAS) (WMD = −0.57, 95% CI −0.91 to −0.23, P = 0.0009) compared with PLA; however, DAA compared with the PLA was increasing in terms of operative time (WMD = 14.81, 95% CI 7.18 to 22.44, P = 0.0001), intraoperative blood loss (WMD = 105.13, 95% CI 25.35 to 184.90, P = 0.01), fracture (WMD = 1.46, 95% CI 1.00 to 2.11, P = 0.05), and Harris hip score (HHS) (WMD = 1.19, 95% CI 0.77 to 1.61, P < 0.00001). Conclusions DAA was preferable effectiveness to PLA in early pain relief and functional recovery; however, PLA has a shorter operation time, intraoperative less blood loss and fracture. Trial registration Registration ID, CRD42020151208

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Efficacy of Acupuncture and Related Techniques on Delirium: Protocol of a Systematic Review and Meta-analysis

10.21203/rs.3.rs-144659/v1 ◽

2021 ◽

Author(s):

Sulan Tan ◽

Yu Zhang ◽

Yiping Bai ◽

Shuting Yang ◽

Liming Luan ◽

...

Keyword(s):

Systematic Review ◽

Systematic Reviews ◽

Guideline Development ◽

Meta Analysis ◽

Length Of Hospital Stay ◽

Cochrane Library ◽

Major Surgery ◽

Cochrane Central Register ◽

Statistical Heterogeneity ◽

The Cochrane Library

Abstract Background: Delirium, contributing to subsequent increased morbidity and mortality, is common in hospitalized patients, especially in patients undergoing major surgery. Published systematic reviews suggest that certain medications for delirium management may decrease pain scores and analgesic requirements, at the expense of troublesome side effects. People are urgently seeking non-medication strategies for delirium. Acupuncture and related techniques (ART) are increasingly used to provide medical care and have potential to prevent delirium, however, the efficacy of ART on delirium remains controversial.Methods: In accordance with the PRISMA-P guidelines, we will search PubMed, Embase, the Cochrane Library (Cochrane Central Register of Controlled Trials (CENTRAL)), Web of Science, Medline and the Cochrane Library for clinical trials on ART use in people, without language restrictions. The incidence of delirium will be defined our primary outcome. Additional outcomes will be the incidence of adverse events, pain score, consumption of analgesics, number of cumulative delirious days, hemodynamics, length of hospital stay. Two researchers independently complete further review work and data abstraction based on pre-specified inclusion and exclusion criteria. Any discrepancy will be solved by negotiation or a third investigators. Cochrane Risk of Bias tool will be used to assess the methodological quality of all the studies that are finally included. Statistical heterogeneity was assessed by forest plots, confidence intervals (CI) and I² statistic. If feasible, a meta-analysis of included results will be performed.Conclusions: This protocol will be favorable to bridge the gap between non-medication strategies and clinical diseases, and potential to help future guideline development in management of preventing delirium.Systematic review registration: The protocol was prospectively registered on the homepage of the International Prospective Register of Systematic Reviews (PROSPERO): https://www.crd.york.ac.uk/PROSPERO.

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Calprotectin, an Emerging Biomarker of Interest in COVID-19: A Systematic Review and Meta-Analysis

Journal of Clinical Medicine ◽

10.3390/jcm10040775 ◽

2021 ◽

Vol 10 (4) ◽

pp. 775

Author(s):

Raphael Udeh ◽

Shailesh Advani ◽

Luis García de Guadiana Romualdo ◽

Xenia Dolja-Gore

Keyword(s):

Systematic Review ◽

Potential Role ◽

Meta Analysis ◽

Pooled Analysis ◽

Severe Form ◽

Cochrane Library ◽

Diagnostic Tools ◽

Rt Pcr ◽

Prognostic Importance ◽

The Cochrane Library

COVID-19 has been shown to present with varied clinical course, necessitating a need for more specific diagnostic tools that could identify severe cases and predict outcomes during COVID-19 infection. Recent evidence has shown an expanded potential role for calprotectin, both as a diagnostic tool and also as a tool in stratifying COVID-19 patients in terms of severity. Therefore, this systematic review and meta-analysis aims to evaluate the levels of calprotectin in severe and non-severe COVID-19 and also identify the implication of raised calprotectin levels. MEDLINE, EMBASE, The Cochrane Library, Web of science and MedRxiv were searched. Meta-analysis was done to compare the serum/fecal levels of calprotectin between severe and non-severe COVID-19 infections. A total of ten studies included in the review (eight had quantitative data while two were qualitative). A pooled analysis of the eight studies from 613 patients who were RT-PCR positive for COVID-19 (average age = 55 years; 52% males) showed an overall estimate as 1.34 (95%CI: 0.77, 1.91). In conclusion, calprotectin levels have been demonstrated to be significantly elevated in COVID-19 patients who develop the severe form of the disease, and it also has prognostic importance.

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EXPRESS: Stroke risk following traumatic brain injury: systematic review and meta-analysis

International Journal of Stroke ◽

10.1177/17474930211004277 ◽

2021 ◽

pp. 174749302110042

Author(s):

Grace Mary Turner ◽

Christel McMullan ◽

Olalekan Lee Aiyegbusi ◽

Danai Bem ◽

Tom Marshall ◽

...

Keyword(s):

Systematic Review ◽

Stroke Risk ◽

Meta Analysis ◽

Vitamin K Antagonists ◽

Cochrane Library ◽

Control Group ◽

Large Sample Size ◽

Hazard Ratios ◽

Increased Risk ◽

The Cochrane Library

Aims To investigate the association between TBI and stroke risk. Summary of review We undertook a systematic review of MEDLINE, EMBASE, CINAHL, and The Cochrane Library from inception to 4th December 2020. We used random-effects meta-analysis to pool hazard ratios (HR) for studies which reported stroke risk post-TBI compared to controls. Searches identified 10,501 records; 58 full texts were assessed for eligibility and 18 met the inclusion criteria. The review included a large sample size of 2,606,379 participants from four countries. Six studies included a non-TBI control group, all found TBI patients had significantly increased risk of stroke compared to controls (pooled HR 1.86; 95% CI 1.46-2.37). Findings suggest stroke risk may be highest in the first four months post-TBI, but remains significant up to five years post-TBI. TBI appears to be associated with increased stroke risk regardless of severity or subtype of TBI. There was some evidence to suggest an association between reduced stroke risk post-TBI and Vitamin K antagonists and statins, but increased stroke risk with certain classes of antidepressants. Conclusion TBI is an independent risk factor for stroke, regardless of TBI severity or type. Post-TBI review and management of risk factors for stroke may be warranted.

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Lumbar Roll Usage While Sitting Reduces the Forward Head Posture in Healthy Individuals: A Systematic Review with Meta-Analysis

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18105171 ◽

2021 ◽

Vol 18 (10) ◽

pp. 5171

Author(s):

Yusuke Handa ◽

Kenya Okada ◽

Hiroshi Takasaki

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Grade System ◽

Cochrane Library ◽

Forward Head Posture ◽

Quality Of Evidence ◽

Head Posture ◽

Head Extension ◽

The Cochrane Library

This systematic review and meta-analysis investigated whether the use of a lumbar roll reduced forward head posture (FHP) while sitting among individuals with or without musculoskeletal disorders. EMBASE, MEDLINE, and the Cochrane Library were systematically searched from their inception to August 2020. The quality of evidence for variables used in the meta-analysis was determined using the GRADE system. Five studies satisfied the criteria for data analysis. All studies included individuals without any spinal symptoms. Data from five studies on neck angle showed a statistically significant (p = 0.02) overall effect (standardized mean difference (SMD) = 0.77), indicating a lesser neck flexion angle while sitting with a lumbar roll than without it. Data from two studies on head angle showed a statistically significant (p = 0.04) overall effect (SMD = 0.47), indicating a lesser head extension angle while sitting with a lumbar roll than without it. In each meta-analysis, the quality of evidence was very low in the GRADE system. The use of a lumbar roll while sitting reduced FHP among individuals without spinal symptoms.

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447 What Age is Best to Perform Myringoplasty?

British Journal of Surgery ◽

10.1093/bjs/znab134.556 ◽

2021 ◽

Vol 108 (Supplement_2) ◽

Author(s):

L Wilks ◽

R Mcleod ◽

V Unadkat

Keyword(s):

Systematic Review ◽

Success Rate ◽

Meta Analysis ◽

Paediatric Population ◽

Cochrane Library ◽

Clear Correlation ◽

Success Rates ◽

Prisma Statement ◽

Transitional Point ◽

The Cochrane Library

Abstract Aim This systematic review and meta-analysis aims to assess this relationship and determine the most appropriate age for recommendation of surgery. Method According to the “Preferred Reporting items for systematic review and meta-analysis” (PRISMA) statement, a literature search was performed across Medline, EMBASE and the Cochrane library from 1946-2018. Articles examining a relationship between age and myringoplasty or type 1 tympanoplasty success rates were screened. Results 20 articles encompassing data from 2244 procedures were included. The overall results conveyed a clear correlation between increasing age and rising success rate. A t-test was conducted which demonstrated a significant (P = 0.05) transition at aged 10, whereby success rate below age 10 was 70.6% and above 10 was 86%. Conclusions This systematic review and meta-analysis has uncovered a clear correlation between increasing age and increasing success rate for myringoplasty in the paediatric population. Furthermore, a significant transitional point has been demonstrated at the age of 10 and We hope that knowledge of increased success rates particularly after the age of 10 helps clinicians make more informed decisions about when to operate

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Traditional Chinese Herb Combined with Surgery versus Surgery for Varicocele Infertility: A Systematic Review and Meta-Analysis

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2015/689056 ◽

2015 ◽

Vol 2015 ◽

pp. 1-8 ◽

Cited By ~ 5

Author(s):

Rong-liang Dun ◽

Min Yao ◽

Long Yang ◽

Xue-jun Cui ◽

Jian-min Mao ◽

...

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Chinese Herb ◽

Chinese Herbs ◽

Cochrane Library ◽

Dichotomous Data ◽

Surgery Group ◽

Traditional Chinese Herb ◽

The Cochrane Library

Objective. The objective of this study was to conduct a systematic review to assess the effectiveness and safety of traditional Chinese herb combined with surgery for male varicocele infertility compared to surgery.Methods. Randomized controlled trials (RCTs) data of traditional Chinese herbs combined with surgery for male varicocele fertility versus surgery were collected by searching the Cochrane Library, Embase, PubMed, and Chinese databases. The risk of bias was assessed using Cochrane Handbook. Study outcomes were presented as risk ratios (RRs) for dichotomous data.Results. Seventeen of 72 potentially relevant trials met the inclusion criteria. The methodological qualities of the RCTs were low. Compared with the surgery group, the traditional Chinese herb combined with surgery group had superiority in pregnancy rate at 3-month (RR=1.76, andP=0.008), 6-month (RR=1.58, andP=0.0005), and 2-year (RR=1.58, andP=0.0005) follow-ups. No RCT was found to describe the side effects.Conclusion. On considering the low methodological quality of RCTs, there was no enough evidence on traditional Chinese herb with surgery for male varicocele infertility, and more high-quality RCTs of large sample sizes are required.

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Intelligence Quotient Outcome Following Epilepsy Surgery in Pediatric Age – A Systematic Review and Meta-Analysis

Journal of Psychiatry & Mental Disorders ◽

10.26420/jpsychiatrymentaldisord.2021.1049 ◽

2021 ◽

Vol 6 (4) ◽

Author(s):

Alferes AR ◽

◽

Oliveiros B ◽

Pereira C ◽

◽

...

Keyword(s):

Systematic Review ◽

Intelligence Quotient ◽

Meta Analysis ◽

Full Scale ◽

Cochrane Library ◽

Pediatric Epilepsy ◽

Pediatric Age ◽

Meta Regression ◽

The Cochrane Library ◽

Intelligence Development

There is a deep-rooted correlation between refractory epilepsy in pediatric age and intelligence development. However, little is known about whether surgical procedures used in pediatric epilepsy treatment can affect Intelligence Quotient (IQ) or not. Factors that might influence postoperative IQ are also a matter of study in several articles. To tackle these issues, a systematic review with meta-analysis was conducted with the terms “epilepsy”, “epileptic”, “surgery”, “surgical”, “Wechsler Scale” and “intelligence tests” in PubMed, the Cochrane Library, EMBASE and Clinical Trials.gov. A descriptive data synthesis was carried out to address each of the objectives and then a metaanalysis using a random effects model was conducted. A meta-regression was performed to ascertain possible factors that could influence postoperative IQ. The meta-analysis of the studies included found a mean difference between postoperative and preoperative full-scale IQ values of 1.014 standardized points (p < 0.001). Among all the articles regarding curative surgeries, only three reported an overall significant improvement in IQ after surgery. Regarding palliative procedures, both studies with anterior corpus callosotomy reported a significant improvement in full-scale IQ values two years after surgery. The meta-regression performed did not find any predictors of change in full-scale IQ.

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Recurrence Rate of Sporadic Pheochromocytomas After Curative Adrenalectomy: A Systematic Review and Meta-analysis

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/clinem/dgaa794 ◽

2020 ◽

Author(s):

Isabelle Holscher ◽

Tijs J van den Berg ◽

Koen M A Dreijerink ◽

Anton F Engelsman ◽

Els J M Nieveen van Dijkum

Keyword(s):

Systematic Review ◽

Recurrence Rate ◽

Meta Analysis ◽

Cochrane Library ◽

Weighted Mean ◽

Curative Surgery ◽

Endocrine Society ◽

Time To Recurrence ◽

The Cochrane Library

Abstract Background Evidence on follow-up duration for patients with sporadic pheochromocytomas is absent, and current guidelines of the European Society of Endocrinology, American Association of Clinical Endocrinologists and Endocrine Surgeons, and the Endocrine Society are ambiguous about the appropriate duration of follow-up. The aim of this systematic review and meta-analysis is to evaluate the recurrence rate of sporadic pheochromocytomas after curative adrenalectomy. Materials and Methods A literature search in PubMed, Embase, and the Cochrane Library was performed. A study was eligible if it included a clear report on the number of sporadic patients, recurrence rate, and follow-up duration. Studies with an inclusion period before 1990, <2 years of follow-up, <10 patients, and unclear data on the sporadic nature of pheochromocytomas were excluded. A meta-analysis on recurrence was performed provided that the heterogeneity was low (I2 < 25%) or intermediate (I2 26–75%). Hozo’s method was used to calculate weighted mean follow-up duration and weighted time to recurrence with combined standard deviations (SDs). Results A total of 13 studies, including 430 patients, were included in the synthesis. The meta-analysis results describe a pooled recurrence rate after curative surgery of 3% (95% confidence interval: 2–6%, I2 = 0%), with a weighted mean time to recurrence of 49.4 months (SD = 30.7) and a weighted mean follow-up period of 77.3 months (SD = 32.2). Conclusions This meta-analysis shows a very low recurrence rate of 3%. Prospective studies, including economical and health effects of limited follow-up strategies for patients with truly sporadic pheochromocytomas should be considered.

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SURG-16. SUPRATOTAL VERSUS GROSS TOTAL RESECTION OF GLIOBLASTOMA: A SYSTEMATIC REVIEW

Neuro-Oncology ◽

10.1093/neuonc/noz175.1017 ◽

2019 ◽

Vol 21 (Supplement_6) ◽

pp. vi243-vi243

Author(s):

Christina Jackson ◽

John Choi ◽

Carrie Price ◽

Chetan Bettegowda ◽

Michael Lim ◽

...

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Gross Total Resection ◽

Cochrane Library ◽

Study Quality ◽

Total Resection ◽

Significant Difference ◽

Definition Of ◽

Supratotal Resection ◽

The Cochrane Library

Abstract INTRODUCTION Due to the infiltrative nature of glioblastoma(GBM) outside of the contrast enhancing region in the peritumoral zone, there is increasing movement to perform supratotal resections (SpTR) by extending the edge of resection beyond the contrast enhancing portion of the tumor. However, there is currently no consensus on the potential survival benefit of SpTR in GBM as compared to gross total resection (GTR). METHODS Therefore, we performed a systematic review using PRISMA guidelines and performed a comprehensive literature search on Pubmed, EMBASE, The Cochrane Library, Web of Science, Scopus, and ClinicalTrials.gov, from inception to August 16, 2018, to identify articles comparing overall survival (OS) after SpTR versus GTR. Furthermore, we assessed study quality using the Oxford Centre for Evidence-Based Medicine guidelines. RESULTS We identified 8902 unique citations, of which 11 articles and 2 abstracts met study inclusion criteria. 925 patients underwent SpTR out of a total of 2137 patients. 9 of the 13 studies demonstrated improved survival with SpTR compared to GTR (median improvement in OS of 10.5 months), with no significant difference in post-operative complication rate. Conversely, one abstract found worsened outcomes with SpTR compared to GTR (median decrease in OS of 4 months). However, overall study quality was poor, with 12 of the 13 studies of level IV evidence and one study of level IIIb evidence. We were unable to perform a meta-analysis due to significant clinical and methodological heterogeneity amongst the studies (e.g. differences in adjuvant therapy and lack of standardization of definition of supratotal resection). CONCLUSIONS Our systematic review indicates that SpTR may be associated with improved OS compared to GTR for GBM. However, this is limited by poor study quality and significant clinical and methodological heterogeneity amongst the studies. There is need for prospective clinical trials to further establish standardized guidelines for SpTR in GBM.

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