scholarly journals Comparison of single- and triple-port VATS for lung cancer: A meta-analysis

Open Medicine ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. 1228-1239
Author(s):  
Yunfei Gao ◽  
Abulaiti Abulimiti ◽  
Dan He ◽  
Anpeng Ran ◽  
Dongbo Luo
Keyword(s):  
Lung Cancer ◽  
Postoperative Pain ◽  
Cohort Studies ◽  
Single Port ◽  
Thoracoscopic Surgery ◽  
Meta Analysis ◽  
Operation Time ◽  
Cochrane Library ◽  
Vats Lobectomy ◽  
Significant Difference

Abstract Objective To compare the perioperative parameters between single- and triple-port video-assisted thoracoscopic surgery (VATS) lobectomy in the treatment of lung cancer. Methods The Pubmed, Embase, Cochrane library, and the Web of Science databases were electronically searched from inception to September 2019 for all relevant studies. Study quality was evaluated using the Jadad scale or the Newcastle-Ottawa scale. The results were pooled using the generic inverse-variance method and expressed as mean differences or risk ratios, with 95% confidence intervals. Results Three randomized controlled trials (RCTs) and ten cohort studies with 2,278 subjects were included in the meta-analysis. Whether based on RCTs or cohort studies, the pooled results showed no significant difference in the operation time, chest tube duration, intraoperative blood loss, postoperative hospital stays, lymph node dissection number, postoperative drainage volume, and postoperative complications between single- and triple-port VATS lobectomy (P > 0.05). Single-port VATS could relieve postoperative pain better than triple-port VATS, especially in the first day and fifth day (P < 0.05). No evidence of significant publication bias was found (P > 0.05). Conclusion Single-port VATS lobectomy can yield similar perioperative results to those of triple-port VATS lobectomy and is more effective in relieving postoperative pain.

scholarly journals Comparison between Minimally Invasive Plate Osteosynthesis and Conventional Open Plating for Midshaft Clavicle Fractures: A Systematic Review and Meta-Analysis

2019 ◽  
Vol 2019 ◽  
pp. 1-9 ◽  
Author(s):  
Enzhe Zhao ◽  
Rui Zhang ◽  
Dou Wu ◽  
Yao Guo ◽  
Qiang Liu
Keyword(s):  
Systematic Review ◽  
Minimally Invasive ◽  
Cohort Studies ◽  
Functional Outcome ◽  
Plate Osteosynthesis ◽  
Meta Analysis ◽  
Operation Time ◽  
Cochrane Library ◽  
Minimally Invasive Plate Osteosynthesis ◽  
Clavicle Fractures

Objective. The aim of this study was to compare the functional outcome and complications in midshaft clavicle fractures receiving minimally invasive plate osteosynthesis and conventional open plating. Methods. Relevant studies were searched in the databases of Medline, EMBASE, Cochrane Library, Ovid, and Web of Science from inception to March 1, 2019. Pooled data were analyzed with Cochrane Collaboration’s Review Manager 5.3. Results. A total of 7 studies were included, of which 2 were randomized controlled trials, 3 were retrospective cohort studies, and 2 were prospective cohort studies including 316 patients. No statistical differences in functional outcome (weighted mean difference [WMD] = 0.99, P=0.12), operation time (WMD = −10.44, P=0.07) and time to bone union (WMD = −0.23, P=0.70) were observed between the two groups. However, minimally invasive plate osteosynthesis reduced rates of skin numbness (odds ratio (OR) = 0.25, 95% CI : 0.13 to 0.48; P<0.0001) and complications (OR = 0.33, 95% CI : 0.16 to 0.71; P=0.005) compared with conventional open plating. Conclusion. This systematic review and meta-analysis found no differences in terms of functional outcomes, operation time, and fracture healing time between minimally invasive plate osteosynthesis and conventional open plating. However, minimally invasive plate osteosynthesis had apparent advantages in rates of skin numbness and complications.

scholarly journals Effect of endoscopic resection on short-term surgical outcomes of subsequent laparoscopic gastrectomy: a meta-analysis

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Dong Peng ◽  
Yu-Xi Cheng ◽  
Gang Liao
Keyword(s):  
Endoscopic Resection ◽  
Laparoscopic Gastrectomy ◽  
Surgical Outcomes ◽  
Meta Analysis ◽  
Operation Time ◽  
Oral Feeding ◽  
Cochrane Library ◽  
Short Term ◽  
Significant Difference ◽  
Grade Ii

Abstract Background Endoscopic resection (ER) might affect subsequent laparoscopic gastrectomy (LG) because of the electrical coagulation, but the effect remains controversial. The purpose of this meta-analysis was to analyze the effect of ER on the short-term surgical outcomes of subsequent LG. Materials and methods The PubMed, EMBASE, and Cochrane Library databases were searched to find eligible studies published from inception to March 21, 2021. Short-term surgical outcomes were compared between the ER-LG group and the LG-only group. The registration ID of this current meta-analysis on PROSPERO is CRD42021238031. Results Nine studies involving 3611 patients were included in this meta-analysis. The LG-only group had a higher T stage (T1-T2: OR=2.42, 95% CI=1.09 to 5.34, P=0.03; T3-T4: OR=0.41, 95% CI=0.19 to 0.91, P=0.03) than the ER-LG group. The ER-LG group showed a shorter operation time than the LG-only group (MD=−5.98, 95% CI=−10.99 to −0.97, P=0.02). However, no difference was found in operation time after subgroup analysis of propensity score matching studies. No significant difference was found in intraoperative blood loss, time to first oral feeding, or postoperative hospital stay between the ER-LG group and the LG-only group. And no significance was found in overall complications (OR=1.16, 95% CI=0.89 to 1.50, P=0.27), complications of grade ≥ II (OR=1.11, 95% CI=0.71 to 1.73, P=0.64), complications of grade ≥ III b (OR=1.47, 95% CI=0.49 to 4.43, P=0.49) between the ER-LG group and the LG-only group. Conclusions ER did not affect subsequent LG in terms of short-term outcomes, and the ER-LG group might have a shorter operation time than the LG-only group.

scholarly journals Meta-Analysis of the Correlation between TCM Syndromes of Lung Cancer and CT through Data Mining and Computer Software

2021 ◽  
Vol 2138 (1) ◽  
pp. 012017
Author(s):  
Yifan Su ◽  
Dehui Li ◽  
Huanfang Fan
Keyword(s):  
Lung Cancer ◽  
Data Mining ◽  
Meta Analysis ◽  
Blood Stasis ◽  
Cochrane Library ◽  
Treatment Level ◽  
Yin Deficiency ◽  
Significant Difference ◽  
Qi Stagnation ◽  
Deficiency Type

Abstract To systematically evaluate the correlation between the traditional Chinese medicine (TCM) syndromes of lung cancer and the imaging manifestations of CT. Computer search of CNKI, Cochrane Library, PubMed, Springer, CBM, VIP, Wanfang database, Baidu library and other major databases. Collect the relevant literature on the TCM syndromes of lung cancer and CT imaging manifestation since the database was built until September 1, 2021. Two researchers collected literature and evaluated the quality of the literature, conducted data mining on the literature, and used the computer Revman 5.3 software to conduct a Meta-analysis of the included literature. The results showed that the phlegm dampness type lobular sign was higher than the burr sign, and there was no significant difference between vacuole sign and cavity sign; In Qi-Yin deficiency type, lobular sign was higher than burr sign, vacuole sign was higher than cavity sign; In Qi stagnation blood stasis type, lobular sign is higher than burr sign. The CT lobular sign of lung cancer are mainly phlegm dampness type, Qi-Yin deficiency type and Qi stagnation blood stasis type. Vacuole sign is mainly Qi-Yin deficiency type. Burr sign and cavity sign are less in the above three types. In this study, the combination of computer and meta-analysis technology has promoted the development of lung cancer micro-differentiation theory and assisted in improving the treatment level of lung cancer clinical syndrome differentiation.

Gallbladder Retrieval From Epigastric Versus Umbilical Port in Laparoscopic Cholecystectomy: A PRISMA-Compliant Meta-Analysis

2019 ◽  
Vol 27 (2) ◽  
pp. 150-159
Author(s):  
Francesco Mongelli ◽  
Davide La Regina ◽  
Irin Zschokke ◽  
Marcello Ceppi ◽  
Antonjacopo Ferrario di Tor Vajana ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Literature Search ◽  
Operative Time ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Trocar Site ◽  
First Choice ◽  
Significant Difference ◽  
Meta Analyses ◽  
Adequate Data

Purpose. To date, no evidence supports the retrieval of the gallbladder through a specific trocar site, and this choice is left to surgeons’ preference. The aim of this meta-analysis was to investigate the influence of the trocar site used to extract the gallbladder on postoperative outcomes. Methods. According to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a literature search of PubMed, Google Scholar, Cochrane Library, and EMBASE databases was performed. Terms used were: (“gallbladder” OR “cholecystectomy”) AND “umbilical” AND (“epigastric” OR “subxiphoid”). Randomized trials comparing the gallbladder retrieval from different trocar sites were considered for further analysis. Results. Literature search revealed 145 articles, of which 7 matched inclusion criteria and reported adequate data about postoperative pain, operative time, port-site infections, and hernias. A total of 876 patients were included, and the gallbladder was extracted through epigastric or umbilical trocar site in 441 and in 435 patients, respectively. A statistically significant difference among groups was noted in terms of postoperative pain at 1, 6, 12, and 24 hours in favor of the umbilical trocar site ( P < .001). No significant differences were noted in postoperative hernia and infection rate, nor in terms of operative time. Conclusions. This meta-analysis shows a statistically significant reduction in terms of postoperative pain at 1, 6, 12, and 24 hours after surgery when the gallbladder is extracted through the umbilical port. Retrieval time, infections, and hernias rate implicate no contraindication for the choice of a specific trocar site to extract specimens. Despite limitations of this study, the umbilical trocar should be favored as the first choice to retrieve the gallbladder.

scholarly journals Roux-en-Y and Billroth II Reconstruction after Pancreaticoduodenectomy: A Meta-Analysis of Complications

2020 ◽  
Vol 2020 ◽  
pp. 1-10
Author(s):  
Fulin Ma ◽  
Yong Fan ◽  
Lina Zhang ◽  
Zhiqiang Zhao ◽  
Yuanhua Nie ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Meta Analysis ◽  
Postoperative Bleeding ◽  
Operation Time ◽  
Cochrane Library ◽  
Controlled Clinical Trials ◽  
Billroth Ii ◽  
Billroth Ii Reconstruction ◽  
Significant Difference ◽  
The Cochrane Library

Objective. To evaluate Roux-en-Y and Billroth II reconstruction following pancreaticoduodenectomy (PD). Methods. PubMed, Embase, the Cochrane Library, and the Web of Science were searched to identify randomized controlled trials (RCTs) and controlled clinical trials that compared Roux-en-Y and Billroth II reconstruction following PD up to December 2019. RevMan 5.3 software was used for the statistical analysis. Results. Four RCTs and five controlled clinical trials were included, with a total of 1,072 patients (500 and 572 patients in the Roux-en-Y and Billroth II groups, respectively). No significant differences in delayed gastric emptying (DGE), A-grade DGE, B-grade DGE, or C-grade DGE were observed between the Roux-en-Y and Billroth II reconstruction groups after PD ( odds   ratio   OR = 1.01 , 95% confidence interval [CI]: 0.50–2.03, P = 0.98 ; OR = 0.49 , 95% CI: 0.17–1.45, P = 0.20 ; OR = 0.63 , 95% CI: 0.29–1.38, P = 0.25 ; and OR = 2.13 , 95% CI: 0.38–11.99, P = 0.39 ). No significant difference in the incidence of postoperative pancreatic fistula, abscess, bile leaks, infection, postoperative bleeding, or the length of the postoperative hospital stay was observed between the Roux-en-Y and Billroth II groups ( P > 0.05 ), but the operation time was significantly different ( mean   difference [MD] = 31.65 , 95% CI: 7.14–56.17, P = 0.01 ). Conclusions. Billroth II reconstruction after PD did not significantly reduce the incidence of DGE or other complications but shortened the operation time compared to Roux-en-Y reconstruction. However, the results must be verified by further high-quality, large RCTs or controlled clinical trials.

Comparison of Postoperative Pain and Recovery between Single-Port and Two-Port Thoracoscopic Lobectomy for Lung Cancer

2018 ◽  
Vol 67 (02) ◽  
pp. 142-146 ◽  
Author(s):  
Zhengcheng Liu ◽  
Rusong Yang ◽  
Feng Shao
Keyword(s):  
Postoperative Pain ◽  
Single Port ◽  
Thoracoscopic Surgery ◽  
Mediastinal Lymph Node ◽  
Perioperative Outcomes ◽  
Vats Lobectomy ◽  
Video Assisted ◽  
Incision Size ◽  
Wound Pain ◽  
Video Assisted Thoracoscopic Surgery

Objective To investigate whether the single-port (SP) technique had more favorable postoperative outcomes than had the two-port (TP) technique. Methods One hundred sixty-six single-port video-assisted thoracoscopic surgery (SP-VATS) lobectomy and 162 two-port video-assisted thoracoscopic surgery (TP-VATS) lobectomy had been successfully completed between August 2015 and September 2016. A single incision of ∼3 cm was made in an intercostal space along the anterior axillary line. Perioperative outcomes and the safety between SP-VATS and TP-VATS lobectomy for NSCLC was compared. Results In the SP-VATS group, incision size was kept to a minimum, with a median of 3 cm; mediastinal lymph node dissection was performed in all patients with malignancy. Overall, median operative time was 89 minutes, and median chest tube duration was 3.1 days. The VAS on postoperative days 3, 7, and 14 was less in the SP-VATS group than that in the TP-VATS group. The VAS on days 1, 30, 60, 90, 180, and 360 did not differ significantly between the two groups. The number of days of use of analgesic agents after surgery was less in the SP-VATS group. The pathological symptoms of wound pain were significantly less in the SP-VATS group. Conclusions Compared with the multiport approach, SP VATS lobectomy might reduce postoperative pain and lead to faster recovery.

scholarly journals Ultrasonic Dissection versus Conventional Dissection for Pancreatic Surgery: A Meta-Analysis

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Haiming Lei ◽  
Dong Xu ◽  
Xinghua Shi ◽  
Koulan Han
Keyword(s):  
Pancreatic Fistula ◽  
Pancreatic Surgery ◽  
Meta Analysis ◽  
Operation Time ◽  
Perioperative Outcomes ◽  
Cochrane Library ◽  
Ultrasonic Dissection ◽  
Significant Difference ◽  
Fistula Rate ◽  
The Cochrane Library

Background. The role of ultrasonic dissection (UD) in pancreatic surgery remains controversial. The aim of this meta-analysis was to evaluate the clinical effect of UD in pancreatic surgery when compared with conventional dissection (CD).Materials and Methods. A comprehensive literature search was performed to identify eligible studies that compared UD with CD for pancreatic surgery in PubMed, EMBASE, Web of Science, and the Cochrane Library. Risk ratio (RR) or mean difference with 95% confidence interval (CI) was calculated.Results. Six studies were included with a total of 215 patients undergoing UD and 210 undergoing CD. In comparison with CD in distal pancreatectomy, UD was associated with lower rates of pancreatic fistula (RR = 0.46, 95% CI: 0.27–0.76) and abdominal abscess and shorter operation time and hospital stay (P<0.05). In pancreaticoduodenectomy, there was no significant difference in pancreatic fistula rate between two groups (RR = 0.79, 95% CI: 0.48–1.29). However, the significantly less intraoperative blood loss and the transfused blood unit were found in patients receiving UD (P<0.05).Conclusions. The results of this meta-analysis show that, in comparison with CD, UD is associated with better perioperative outcomes in pancreatic surgery.

scholarly journals Comparison of the Effects of TIPS versus BRTO on Bleeding Gastric Varices: A Meta-Analysis

2020 ◽  
Vol 2020 ◽  
pp. 1-9 ◽  
Author(s):  
Zi Wen Wang ◽  
Jin Chao Liu ◽  
Fang Zhao ◽  
Wen Guang Zhang ◽  
Xu Hua Duan ◽  
...  
Keyword(s):  
Hepatic Encephalopathy ◽  
Cohort Studies ◽  
Success Rate ◽  
Meta Analysis ◽  
Gastric Varices ◽  
Cochrane Library ◽  
Technical Success ◽  
Technical Success Rate ◽  
Significant Difference ◽  
Rebleeding Rate

Background and Aim. Upper gastrointestinal bleeding is a threat to patients with gastric varices (GVs). Previous studies have concluded that both transjugular intrahepatic portosystemic shunt (TIPS) and balloon-occluded retrograde transvenous obliteration (BRTO) are effective treatments for patients with GV. We aimed to compare the efficiency and outcomes of these two procedures in GV patients through meta-analysis. Methods. The PubMed, Cochrane Library, EMBASE, and Web of Science databases were searched using the keywords: GV, bleeding, TIPS, and BRTO to identify relevant randomized controlled trials and cohort studies. The overall survival (OS) rate, imminent haemostasis rate, rebleeding rate, technical success rate, procedure complication rate (hepatic encephalopathy and aggravated ascites), and Child-Pugh score were evaluated. Randomized clinical trials and cohort studies comparing TIPS and BRTO for GV due to portal hypertension were included in our meta-analysis. Two independent reviewers performed data extraction and assessed the study quality. A meta-analysis was performed to calculate risk ratios (RRs), mean differences (MDs), and 95% CIs using random effects models. Results. A total of nine studies fulfilled the inclusion criteria. There was a significant difference between TIPS and BRTO in the OS rate (RR, 0.81 (95% CI, 0.66 to 0.98); P=0.03) and rebleeding rate (RR, 2.61 (95% CI, 1.75 to 3.90); P<0.00001). TIPS had a higher incidence rate of hepatic encephalopathy (RR, 16.11 (95% CI, 7.13 to 36.37); P<0.00001). There was no significant difference between TIPS and BRTO in the immediate haemostasis rate (RR, 0.99 (95% CI, 0.89 to 1.10); P=0.84), technical success rate (RR, 1.06 (95% CI, 0.98 to 1.16); P=0.16), aggravated ascites rate (RR, 0.60 (95% CI, 0.33 to 1.09); P=0.10), or Child-Pugh change (MD, 0.22 (95% CI, −0.21 to 0.65); P=0.31). Conclusions. In this meta-analysis, BRTO brought more benefits to patients, with a higher OS rate and lower rebleeding rate. BRTO is a feasible method for GVB.

scholarly journals Microscopic Versus Endoscopic Stapes Surgery: A Systematic Review and Meta-analysis

2021 ◽  
Author(s):  
JIANNIS HAJIIOANNOU ◽  
Eleni Gkrinia ◽  
Konstantinos Tzimkas-Dakis ◽  
Effrosyni Palla ◽  
Alexandros Brotis ◽  
...  
Keyword(s):  
Success Rate ◽  
Meta Analysis ◽  
Operation Time ◽  
Stapes Surgery ◽  
Cochrane Library ◽  
Efficacy And Safety ◽  
Quality Of Evidence ◽  
Randomized Controlled Studies ◽  
Significant Difference

Objectives Endoscopic approaches constitute a newly introduced and promising technique in the field of stapes surgery, presenting favorable outcomes, so far. This study aims to compare endoscopic and microscopic stapes surgery based on current literature evidence, in terms of their efficacy and safety characteristics. Design We conducted a systematic literature search of three medical databases (Pubmed, Cochrane Library, and Scopus). We focused on randomized controlled studies or observational studies comparing microscopic to endoscopic stapes surgery. Data related to the efficacy and safety of each technique were extracted. Outcome data were summarized using the pooled mean differences or pooled odds ratio along with their 95% confidence intervals, according to the available data. The quality of evidence was assessed according to the GRADE recommendations. Results Thirteen studies with 705 patients were included in the meta-analysis. Success rate was evaluated by estimating air-bone gap improvement, resulting in comparable outcomes for the two techniques (mean difference: -0.20; 95% CI: -0.53, 0.14). No statistically significant difference was detected concerning postoperative complications, except for dysgeusia that was in favor of the endoscopic approach (OR: -1.46; 95% CI: -2.45, -.047). The overall quality of evidence was assessed to range from “Low” to “Very Low”. Conclusion Endoscopic stapes surgery is an innovative alternative to the microscopic technique, resulting in commensurate outcomes in terms of success rate and complications. Further high-quality studies are needed, to adequately compare the two approaches, particularly in terms of operation time, learning curve, cost-effectiveness, and otology surgical skills acquisition.

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