S0908 Outcomes of Endoscopic vs Surgical Approach for Ampullary Adenoma: A Systematic Review and Meta-Analysis

Abstract Background This systematic review and meta-analysis searched, retrieved and synthesized the evidence as to whether preoperative esophagogastroduodenoscopy (p-EGD) should be routine before bariatric surgery (BS). Methods Databases searched for retrospective, prospective, and randomized (RCT) or quasi-RCT studies (01 January 2000–30 April 2019) of outcomes of routine p-EGD before BS. STROBE checklist assessed the quality of the studies. P-EGD findings were categorized: Group 0 (no abnormal findings); Group 1 (abnormal findings that do not necessitate changing the surgical approach or postponing surgery); Group 2 (abnormal findings that change the surgical approach or postpone surgery); and Group 3 (findings that signify absolute contraindications to surgery). We assessed data heterogeneity and publication bias. Random effect model was used. Results Twenty-five eligible studies were included (10,685 patients). Studies were heterogeneous, and there was publication bias. Group 0 comprised 5424 patients (56%, 95% CI: 45–67%); Group 1, 2064 patients (26%, 95% CI: 23–50%); Group 2, 1351 patients (16%, 95% CI: 11–21%); and Group 3 included 31 patients (0.4%, 95% CI: 0–1%). Conclusion For 82% of patients, routine p-EGD did not change surgical plan/ postpone surgery. For 16% of patients, p-EGD findings necessitated changing the surgical approach/ postponing surgery, but the proportion of postponements due to medical treatment of H Pylori as opposed to “necessary” substantial change in surgical approach is unclear. For 0.4% patients, p-EGD findings signified absolute contraindication to surgery. These findings invite a revisit to whether p-EGD should be routine before BS, and whether it is judicious to expose many obese patients to an invasive procedure that has potential risk and insufficient evidence of effectiveness. Further justification is required.

Download Full-text

From hysteroscopy to laparoendoscopic surgery: what is the best surgical approach for symptomatic isthmocele? A systematic review and meta-analysis

Archives of Gynecology and Obstetrics ◽

10.1007/s00404-020-05438-0 ◽

2020 ◽

Vol 301 (1) ◽

pp. 33-52 ◽

Cited By ~ 6

Author(s):

Salvatore Giovanni Vitale ◽

Artur Ludwin ◽

George Angelos Vilos ◽

Péter Török ◽

Jan Tesarik ◽

...

Keyword(s):

Systematic Review ◽

Surgical Approach ◽

Meta Analysis

Download Full-text

Ameloblastoma em maxila: sugestão de abordagem cirúrgica

ARCHIVES OF HEALTH INVESTIGATION ◽

10.21270/archi.v7i12.3097 ◽

2019 ◽

Vol 7 (12) ◽

Author(s):

Thalles Moreira Suassuna ◽

Júlio Leite de Araújo-Júnior ◽

Tácio Candeia Lyra ◽

Joaquim Celestino da Silva-Neto ◽

José Wilson Noleto ◽

...

Keyword(s):

Systematic Review ◽

Recurrence Rate ◽

Surgical Approach ◽

Femoral Condyle ◽

Meta Analysis ◽

Infratemporal Fossa ◽

Le Fort ◽

Maxillary Defect ◽

Le Fort I ◽

Head Neck

Introdução: O ameloblastoma é um tumor benigno, localmente invasivo, originário do epitélio odontogênico e é a neoplasia odontogênica mais comum. Apresentam crescimento lento e sua ocorrência na maxila é pouco frequente. Objetivo: Discutir os métodos de tratamento para os ameloblastomas em maxila e demonstrar a utilidade da osteotomia Le Fort I na abordagem destas lesões. Material e Método: Estudo descritivo de relato de caso. Resultados: Observou-se a erradicação da lesão com uma abordagem de baixa morbidade e que permitiu bom resultado estético e funcional. Conclusão: A ressecção é o método mais indicado para tratamento dos ameloblastomas sólidos, e a sua realização utilizando a osteotomia Le Fort I podem trazer vantagens tanto no trans quanto no pós-operatório.Descritores: Ameloblastoma; Maxila; Osteotomia de Le Fort.ReferênciasKreppel M, Zöller J. Ameloblastoma - Clinical, radiological, and therapeutic findings. Oral Dis. 2018;24(1-2):63-6.Taylor EM, Wu W, Kamali W, Ferraro P, Upton N, Lin J et al. Medial femoral condyle flap reconstruction of a maxillary defect with a 3D printing template. J Reconstr Microsurg Open. 2017;2:e63-8.Menezes LM, Souza CEL, Carneiro JT, Silva Kataoka MS, Júnior SDMA, Pinheiro, JDJV. Maxillary ameloblastoma in an elderly patient: report of a surgical approach. Hum Pathol. 2017;10:25-9.Laborde A, Nicot R, Wojcik T, Ferri J, Raoul G. Ameloblastoma of the jaws: Management and recurrence rate. Eur Ann Otorhinolaryngol Head Neck Dis. 2017;134(1):7-11. Milman T, Ying GS, Pan W, LiVolsi V. Ameloblastoma: 25 year experience at a single institution. Head Neck Pathol. 2016;10(4):513-20.Pogrel MA, Montes DM. Is there a role for enucleation in the management of ameloblastoma? Int J Oral Maxillofac Surg. 2009;38(8):807-12.Antonoglou GN, Sándor GK. Recurrence rates of intraosseous ameloblastomas of the jaws: a systematic review of conservative versus aggressive treatment approaches and meta-analysis of non-randomized studies. J Craniomaxillofac Surg. 2015;43(1):149-57.Almeida RA, Andrade ES, Barbalho JC, Vajgel A, Vasconcelos BC. Recurrence rate following treatment for primary multicystic ameloblastoma: systematic review and meta-analysis. Int J Oral Maxillofac Surg. 2016;45(3):359-67.Rizzitelli A, Smoll N, Chae M, Rozen WM, Hunter-Smith DJ. Incidence and overall survival of malignant ameloblastoma. PLoS One. 2015;10(2):e0117789.Nastri AL, Wiesenfeld D, Radden BG, Eveson J, Scully C. Maxillary ameloblastoma: a retrospective study of 13 cases. Br J Oral Maxillofac Surg. 1995;33(1):28-32.Guha A, Hart L, Polachova H, Chovanec M, Schalek P. Partial maxillectomy for ameloblastoma of the maxilla with infratemporal fossa involvement: A combined endoscopic endonasal and transoral approach. J Stomatol Oral Maxillofac Surg. 2018;119(3):212-15.Quick-Weller J, Koch F, Dinc N, Lescher S, Baumgarten P, Harter P et al. Intracranial ameloblastoma arising from the maxilla: an interdisciplinary surgical approach. J Neurol Surg A Cent Eur Neurosurg. 2017;78(5):582-87.Abtahi MA, Zandi A, Razmjoo H, Ghaffari S, Abtahi SM, Jahanbani-Arkadani H et al. Orbital invasion of ameloblastoma: a systematic review apropos of a rare entity. J Curr Ophthalmol. 2018;30(1):23-34.Bettoni J, Neiva C, Fanous A, Olivetto M, Demarteleire S, Demarteleire C et al. Brain ameloblastoma: metastasis or local extension report of a case and literature review. J Stomatol Oral Maxillofac Surg. 2018;119(5):436-39.Yang R, Liu Z, Peng C, Cao W, Ji T. Maxillary ameloblastoma: factors associated with risk of recurrence. Head Neck. 2017;39(5):996-1000.Kamalpathey LCK, Sahoo MGNK, Chattopadhyay CPK, Issar MY. Access Osteotomy in the Maxillofacial Skeleton. Ann Maxillofac Surg. 2017;7(1):98-103.Alexander R, Weber WD, Theodos LV, Friedman JS. The treatment of large benign maxillary tumors via Le Fort I downfracture: report of two cases and review of the literature. J Oral Maxillofac Surg. 1992;50(5):515-7.Catunda IS, Melo AR, Medeiros Júnior R, Queiroz IV, Neto F, Leão JC. Osteotomia Le Fort I: Aspectos de interesse no tratamento de nasoangiofibroma juvenil. Rev cir traumatol buco-maxilo-fac. 2011;11(4):9-12.Symington OG, Caminiti MF. Le Fort 1 down fracture approach for the treatment of a posterior maxillary ameloblastoma. J Can Dent Assoc. 1995;61(12):1048-52.Iwaki LC, Tolentino ES, Lustosa RM, Jacomacci WP, Casaroto AR, Leite PC et al. Le Fort I osteotomy for the removal of a rare unicystic ameloblastoma lesion in the maxillary sinus. Gen Dent. 2016;64(3):16-9.

Download Full-text

AXILLARY SURGICAL APPROACH IN METASTATIC BREAST CANCER PATIENTS: A SYSTEMATIC REVIEW AND META-ANALYSIS

10.29289/259453942019v29s1cp03 ◽

2019 ◽

Author(s):

Fabiana C.A.P. Lisboa ◽

◽

Roberta B. Silva ◽

Keitty R. C. de Andrade ◽

Ana Claudia M.G. Figueiredo ◽

...

Keyword(s):

Breast Cancer ◽

Systematic Review ◽

Metastatic Breast Cancer ◽

Cancer Patients ◽

Surgical Approach ◽

Meta Analysis ◽

Metastatic Breast ◽

Breast Cancer Patients

Download Full-text

Outcomes of sinonasal inverted papilloma resection by surgical approach: an updated systematic review and meta‐analysis

International Forum of Allergy & Rhinology ◽

10.1002/alr.22305 ◽

2019 ◽

Vol 9 (6) ◽

pp. 573-581 ◽

Cited By ~ 8

Author(s):

Rui Peng ◽

Andrew Thamboo ◽

Garret Choby ◽

Yifei Ma ◽

Bing Zhou ◽

...

Keyword(s):

Systematic Review ◽

Surgical Approach ◽

Meta Analysis ◽

Inverted Papilloma ◽

Sinonasal Inverted Papilloma

Download Full-text

Systematic review and meta-analysis on juvenile primary spontaneous pneumothorax: Conservative or surgical approach first?

PLoS ONE ◽

10.1371/journal.pone.0250929 ◽

2021 ◽

Vol 16 (4) ◽

pp. e0250929

Author(s):

Chun-Shan Hung ◽

Yang-Ching Chen ◽

Ten-Fang Yang ◽

Fu-Huan Huang

Keyword(s):

Systematic Review ◽

Recurrence Rate ◽

Surgical Approach ◽

Spontaneous Pneumothorax ◽

Meta Analysis ◽

Optimal Choice ◽

Primary Spontaneous Pneumothorax ◽

First Line ◽

Mean Differences ◽

Meta Analyses

Background Primary spontaneous pneumothorax (PSP) prevalence is typically higher in juvenile patients than in adults. We aimed to evaluate the optimal treatment for primary spontaneous pneumothorax and its efficacy and safety in juveniles. Materials and methods We searched PubMed, Embase, and Cochrane databases for eligible studies published from database inception to October 10, 2020, and conducted a systematic review and meta-analysis according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The primary and secondary outcomes were recurrence rate and hospital stay length, respectively. Odds ratios (OR) and mean differences were used for quantitatively analyzing binary and continuous outcomes, respectively. In total, nine retrospective studies with 1,452 juvenile patients (aged <21) were included for the quantitative analysis. The surgical approach led to a lower recurrence rate than did conservative approaches (OR: 1.95, 95% confidence interval: 1.15–3.32). Moreover, the recurrence rate was low in patients who underwent conservative treatment first and received surgery later. Conclusions Surgical approach for first-line management might have a greater effect on recurrence prevention than do conservative approaches. An upfront surgery might be an optimal choice for juvenile primary spontaneous pneumothorax.

Download Full-text