scholarly journals A meta-analysis of fast track surgery for patients with gastric cancer undergoing gastrectomy

2015 ◽  
Vol 97 (1) ◽  
pp. 3-10 ◽  
Author(s):  
S Chen ◽  
Z Zou ◽  
F Chen ◽  
Z Huang ◽  
G Li
Keyword(s):  
Gastric Cancer ◽  
Perioperative Care ◽  
Fast Track ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Fast Track Surgery ◽  
Short Term ◽  
Readmission Rates ◽  
Randomised Controlled

Introduction This meta-analysis evaluated the safety and efficacy of fast track surgery (FTS) for patients with gastric cancer undergoing gastrectomy. Methods Randomised controlled trials (RCTs) published between 1 January 1995 and 21 June 2013 comparing FTS with conventional perioperative care for patients with gastric cancer undergoing gastrectomy were identified in the PubMed, Embase™ and Cochrane Library databases, and were analysed systematically using RevMan software (Nordic Cochrane Centre, Copenhagen, Denmark). Results Seven RCTs (524 patients) were analysed. Compared with conventional perioperative care, FTS treatment with/without laparoscopy was associated with shorter postoperative hospitalisation, less hospitalisation expenditure (both p<0.00001), less pain and better quality of life. Short-term morbidity and readmission rates did not differ between treatments. No incidents of death occurred during the short-term follow-up period. Conclusions In patients with gastric cancer undergoing gastrectomy, the FTS pathway reduces the length and cost of postoperative hospitalisation while maintaining short-term morbidity, readmission and mortality rates comparable with those of conventional care.

Simultaneous compared to interval administration of mifepristone and misoprostol for medical abortion up to 10+0 weeks' gestation: a systematic review with meta-analyses

2020 ◽  
pp. bmjsrh-2019-200448
Author(s):  
Mia Schmidt-Hansen ◽  
Jonathan Lord ◽  
Elise Hasler ◽  
Sharon Cameron
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Cochrane Collaboration ◽  
Medical Abortion ◽  
Cochrane Library ◽  
Published Data ◽  
Study Results ◽  
Randomised Controlled ◽  
Meta Analyses

BackgroundMedical abortion with mifepristone and misoprostol usually involves an interval of 36–48 hours between administering these drugs; however, it is possible that the clinical efficacy at early gestations may be maintained when the drugs are taken simultaneously. The objective of this systematic review was to determine the safety and effectiveness of simultaneous compared with interval administration of mifepristone and misoprostol for abortion up to 10+0 weeks’ gestation.MethodsWe searched Embase Classic, Embase; Ovid MEDLINE(R) including Daily, and Epub Ahead-of-Print, In-Process & Other Non-Indexed Citations; and Cochrane Library on 11 December 2019. We included randomised controlled trials (RCTs), published in English from 1985, comparing simultaneous to interval administration of mifepristone and misoprostol for early abortion. Risk of bias was assessed using the Cochrane Collaboration checklist for RCTs. Meta-analysis of risk ratios (RRs) using the Mantel-Haenszel method were performed. The quality of the evidence was assessed using GRADE.ResultsMeta-analyses of three RCTs (n=1280) showed no differences in ‘ongoing pregnancy’ (RR 1.78, 95% CI 0.38 to 8.36), ‘haemorrhage requiring transfusion or ≥500 mL blood loss’ (RR 0.11, 95% CI 0.01 to 2.03) and ‘incomplete abortion with the need for surgical intervention’ (RR 1.30, 95% CI 0.76 to 2.25) between the interventions. Individual study results showed no difference in patient satisfaction, or ‘need for repeat misoprostol’, although ‘time to onset of bleeding or cramping’ was longer after simultaneous than interval administration. The quality of evidence was very low to moderate.ConclusionThe published data support the use of simultaneous mifepristone and misoprostol for medical abortion up to 9+0 weeks in women who prefer this method of administration.

Surgical or medical abortion of pregnancies between 13+0 and 23+6 weeks’ gestation? A systematic review and new NICE national guidelines

2020 ◽  
pp. bmjsrh-2019-200460
Author(s):  
Mia Schmidt-Hansen ◽  
Patricia A Lohr ◽  
Sharon Cameron ◽  
Elise Hasler
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Cochrane Collaboration ◽  
Medical Abortion ◽  
Cochrane Library ◽  
National Guidelines ◽  
Cervical Injury ◽  
Surgical Methods ◽  
Randomised Controlled

BackgroundAbortion in the second trimester may be performed surgically or medically. The objective of this systematic review was to examine the effectiveness, safety and acceptability/satisfaction of surgical compared with medical abortion of pregnancy between 13+0 and 23+6 weeks’ gestation for a new national guideline.MethodsWe searched Embase, Medline and the Cochrane Library on 4 March 2019. We included randomised controlled trials (RCTs; any size) and non-randomised comparative studies with n≥100 in each arm, published in English from 1985. Risk-of-bias was assessed using the Cochrane Collaboration checklist for RCTs. Meta-analysis of risk ratios (RRs)used the Mantel-Haenszel method. The quality of the evidence was assessed using GRADE.ResultsTwo RCTs (n=140) were included. ‘Incomplete abortion requiring surgical intervention’ was clinically significantly higher with medical than surgical methods (RR=4.58, 95% CI 1.07 to 19.64). ‘Abortion completed by the intended method’ was statistically, but not clinically, significantly lower after medical than surgical methods, but was marked by high between-study heterogeneity (RR=0.88, 95% CI 0.79 to 0.98). To the extent that ‘haemorrhage requiring transfusion/≥500 mL blood loss’, ‘uterine injury’, ‘cervical injury requiring repair’ and ‘infection reported within 1 month of abortion’ were reported, they did not differ significantly between methods. Depending on measurement method, ‘patient satisfaction/acceptability’ was either clinically significantly higher or comparable after surgical than medical methods. The quality of this evidence was limited by low event rates and attrition bias.ConclusionBased on this evidence and consensus, women should be offered the choice of medical or surgical methods of abortion between 13+0 and 23+6 weeks’ gestation, unless not clinically appropriate.

scholarly journals Fast-track surgery versus traditional perioperative care in laparoscopic colorectal cancer surgery: a meta-analysis

BMC Cancer ◽  
2014 ◽  
Vol 14 (1) ◽  
Author(s):  
Jun-hua Zhao ◽  
Jing-xu Sun ◽  
Peng Gao ◽  
Xiao-wan Chen ◽  
Yong-xi Song ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Perioperative Care ◽  
Fast Track ◽  
Meta Analysis ◽  
Cancer Surgery ◽  
Fast Track Surgery ◽  
Colorectal Cancer Surgery

scholarly journals Effect of vitamins C and E supplementation onHelicobacter pylorieradication: a meta-analysis

2011 ◽  
Vol 106 (11) ◽  
pp. 1632-1637 ◽  
Author(s):  
Guogang Li ◽  
Lan Li ◽  
Chaohui Yu ◽  
Li Chen
Keyword(s):  
Methodological Quality ◽  
Eradication Rate ◽  
Small Sample Size ◽  
Meta Analysis ◽  
Small Sample ◽  
Cochrane Library ◽  
Significant Difference ◽  
H Pylori ◽  
Randomised Controlled

Vitamins C and E can act as potent antioxidants to reduce the damage caused by reactive oxygen species in gastric mucosa. Whether vitamin supplements forHelicobacter pylorieradication regimen could improve the rate of eradication remains uncertain. Therefore, we performed a meta-analysis to evaluate the efficacy of vitamins C and E supplementation for the eradication ofH. pylori. Searches were conducted in the databases PubMed, EMBASE and Cochrane Library. Randomised controlled trials (RCT) that fulfilled the inclusion criteria and addressed the clinical questions of this analysis were further assessed. Of the six RCT included, five had a low methodological quality. Of the six RCT, three compared the efficacy of the eradication regimenv.eradication regimen plus vitamins C and E. The result of the meta-analysis showed a non-significant difference in the eradication rate ofH. pyloribetween the two groups (risk ratio (RR) 0·93,P = 0·76). Another three RCT compared the eradication regimenv.eradication regimen plus vitamin C only, and there too there was no significant difference in the eradication rate (RR 0·83,P = 0·32). In conclusion, vitamins C and/or E supplements to theH. pylorieradication regimen could not improve the eradication rate. However, currently available data do not draw a definitive conclusion about the effectiveness of antioxidant vitamins onH. pylorieradication, owing to the small sample size and low-to-moderate methodological quality.

Meta-Analysis of Efficacy and Safety of Fast-Track Surgery in Gastrectomy for Gastric Cancer

2014 ◽  
Vol 38 (12) ◽  
pp. 3142-3151 ◽  
Author(s):  
Yuan-jun Li ◽  
Ting-ting Huo ◽  
Juan Xing ◽  
Jia-ze An ◽  
Zhe-yi Han ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Fast Track ◽  
Meta Analysis ◽  
Efficacy And Safety ◽  
Fast Track Surgery

scholarly journals A Comprehensive Comparison of LRYGB and LSG in Obese Patients Including the Effects on QoL, Comorbidities, Weight Loss, and Complications: a Systematic Review and Meta-Analysis

2019 ◽  
Vol 30 (3) ◽  
pp. 819-827 ◽  
Author(s):  
Zhihao Hu ◽  
Junfeng Sun ◽  
Ruixin Li ◽  
Zhuoyin Wang ◽  
Hengxuan Ding ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Weight Loss ◽  
Meta Analysis ◽  
Late Complications ◽  
Cochrane Library ◽  
Life Questionnaire ◽  
Obese Patients ◽  
Short Term

Abstract Purpose To systematically and comprehensively evaluate the differences between laparoscopic Roux-en-Y gastric bypass (LRYGB) versus sleeve gastrectomy (LSG) in obese patients. Methods A systematic literature search was performed in PubMed, EMBASE, Web of Science, and the Cochrane Library from inception to December 2018. The meta-analysis was performed by the RevMan 5.3 software. Results Twenty-three articles with 7443 patients were included. In short term (< 3 years), LRYGB was superior to LSG in terms of improving comorbidities (T2D, odds ratio (OR) 1.93, 1.06–3.52, P < 0.05, hypertension, OR 1.59, 1.08–2.34, P < 0.05, dyslipidemia, OR 1.61, 1.05–2.46, P < 0.05), but there were no differences in the midterm and long term. Quality of life (QoL) after bariatric surgery was included, but no differences were observed in the QoL after LRYGB or LSG (gastrointestinal quality of life index (GIQLI) and Moorehead–Ardelt quality of life questionnaire (M-A-Q), P > 0.05). LRYGB achieved a higher EWL% than LSG (after 3 years, WMD 5.48, 0.13–10.84. P < 0.05; after 5 years, WMD 4.55, 1.04–8.05, P < 0.05) in long term, but no significant differences were found during 0.25- to 2.0-year follow-up. The rate of early and late complications was much higher in LRYGB than in LSG (early complications, OR = 2.11, 95% CI = 1.53–2.91, P < 0.001; late complications, OR = 2.60, 95% CI = 1.93–3.49, P < 0.001). Conclusions This meta-analysis showed that LRYGB was more effective than LSG in comorbidities’ resolution or improvement in short term. For weight loss, LRYGB had better long-term effects than LSG. In addition, no differences were observed in the quality of life after LRYGB or LSG. LRYGB was associated with more complications than LSG.

scholarly journals Effectiveness and safety of manual acupuncture therapy in patients with post-stroke depression: a protocol for a systematic review and meta-analysis

BMJ Open ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. e048686
Author(s):  
Wei Liu ◽  
Chang Rao ◽  
Qi Zhao ◽  
Yuzheng Du ◽  
Xi Nan ◽  
...  
Keyword(s):  
Acupuncture Therapy ◽  
Emotional Disorders ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Manual Acupuncture ◽  
China National Knowledge Infrastructure ◽  
Post Stroke ◽  
Post Stroke Depression ◽  
Randomised Controlled

IntroductionAcupuncture is widely used on the rehabilitation of stroke survivors, including hemiplegia, constipation, emotional disorders and so on. Although the effectiveness of manual acupuncture therapy on post-stroke depression (PSD) has been confirmed by multiple randomised controlled trials, there were few meta-analyses focused on the connection between different techniques, durations or other detailed operations of manual acupuncture and their effectiveness of improving the depression severity and quality of life for patients with PSD.Methods and analysisA systematic search will be performed on English databases (PubMed, the Cochrane Library, Medline and Embase), Chinese databases (China National Knowledge Infrastructure, WanFang Data, VIP and Chinese biomedical databases) and Japanese databases (Japan Science and Technology Agency and CiNii). The retrieval time limit will be from the establishment of the database to November 2020. Two researchers will independently screen the literature works, extract data and evaluate the quality of the included studies. Meta-analysis will be conducted by using STATA V.14.0 and Review Manager V.5.3.Ethics and disseminationThe results of this meta-analysis will be disseminated through publication in peer-reviewed journals or conference presentations. The data used in this meta-analysis will not contain individual patient data; therefore, ethical approval is not required.PROSPERO registration numberCRD42020222825.

scholarly journals A meta-analysis into the effect of lateral-wedged insoles with subtalar strapping versus traditional insoles in adults with medial knee osteoarthritis.

2011 ◽  
Vol 67 (1) ◽  
Author(s):  
L. Duvenhage ◽  
T. Mushaike ◽  
N. Parker ◽  
L. Swartz ◽  
M. Rensburg ◽  
...  
Keyword(s):  
Knee Osteoarthritis ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Narrative Form ◽  
Short Term ◽  
Medial Knee ◽  
Medial Knee Osteoarthritis ◽  
Knee Oa ◽  
Randomised Controlled

To  systematically  identify,  collate,  and  analyze  the  current available evidence  for  the  effectiveness  of  lateral-wedged  insoles,  with subtalar strapping,  on  reducing  pain,  improving  function  and  improving  the femoral-tibial  angle  (FTA),  in  adults  with  medial  knee osteoarthritis compared to traditional insoles without subtalar strapping.Six computerised databases, namely Cochrane Library, CiNAHL, PEDro, BIOMED central,  PubMed  and  ScienceDirect  were  searched. The  included articles were  then  all  rated  using  the  PEDro  scale  to  determine  their meth-odological quality.  Homogeneous data were pooled in a meta-analysis using Review Manager (REVMAN) software.  Where statistical pooling of the results was not possible, findings were summarised in narrative form. Three randomised controlled trials were selected for this review. The average PEDro score was 5.7. A meta-analysis demonstrated that lateral-wedged insoles with subtalar strapping significantly reduced pain in the short-term (p=0.004). The review found that lateral-wedge insoles with subtalar strapping significantly decreased pain in the short-term and seemed to have a positive effect on the FTA in the long-term, when compared to traditional insoles without  subtalar strapping. The lateral-wedge insole with subtalar strapping may provide a financially feasible adjunctive self-management treatment for knee OA and should be considered before invasive procedures such as surgery.

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