AB191. Predictors of conversion from minimally invasive to open adrenalectomy—a systematic review and meta-analysis of observational studies

Summary Limited uptake of minimally invasive surgery (MIS) of the aorta hinders assessment of its efficacy compared to median sternotomy (MS). The objective of this systematic review is to compare operative and perioperative outcomes for MIS versus MS. Online databases Medline, EMBASE, Cochrane Library and Web of Science were searched from inception until July 2018. Both randomized and observational studies of patients undergoing aortic root, ascending aorta or aortic arch surgery by MIS versus MS were eligible for inclusion. Primary outcomes were 30-day mortality, reoperation for bleeding, perioperative renal impairment and neurological events. Intraoperative and postoperative timing measures were also evaluated. Thirteen observational studies were included comparing 1101 MIS and 1405 MS patients. The overall quality of evidence was very low for all outcomes. Mortality and the incidence of stroke were similar between the 2 cohorts. Meta-analysis demonstrated increased length of cardiopulmonary bypass (CPB) time for patients undergoing MS [standardized mean difference 0.36, 95% confidence interval (CI) 0.15–0.58; P = 0.001]. Patients receiving MS spent more time in hospital (standardized mean difference 0.30, 95% CI 0.17–0.43; P < 0.001) and intensive care (standardized mean difference 0.17, 95% CI 0.06–0.27; P < 0.001). Reoperation for bleeding (risk ratio 1.51, 95% CI 1.06–2.17; P = 0.024) and renal impairment (risk ratio 1.97, 95% CI 1.12–3.46; P = 0.019) were also greater for MS patients. There was substantial heterogeneity in meta-analyses for CPB and aortic cross-clamp timing outcomes. MIS may be associated with improved early clinical outcomes compared to MS, but the quality of the evidence is very low. Randomized evidence is needed to confirm these findings.

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Minimally invasive versus transcatheter closure of secundum atrial septal defects: a systematic review and meta-analysis

Perfusion ◽

10.1177/02676591211021935 ◽

2021 ◽

pp. 026765912110219

Author(s):

Esther Goh ◽

Haya Mohammed ◽

Mohammad Yusuf Salmasi ◽

Samantha Ho ◽

Umberto Benedetto ◽

...

Keyword(s):

Systematic Review ◽

Minimally Invasive ◽

Observational Studies ◽

Transcatheter Closure ◽

Meta Analysis ◽

Limited Data ◽

Septal Defects ◽

Atrial Septal Defects ◽

Operative Outcomes ◽

Asd Closure

Background: Limited data exists demonstrating the efficacy of minimally invasive surgery (MIS) compared to transcatheter (TC) closure of atrial septal defects (ASD). This systematic review and meta-analysis aims to compare post-operative outcomes of MIS versus TC repair in ASD closure. Methods: PubMed, Medline and EMBASE were searched from inception until June 2018 for randomised and observational studies comparing post-operative outcomes for MIS and TC repair. The studies were reviewed for bias using the ROBINS-I Score and pooled in a meta-analysis using STATA (version 15). Results: Six observational studies, involving 1524 patients assessing three primary and five secondary outcomes were included. Evidence suggests TC repair yielded shorter hospital stay (MD = 3.32, 95% CI 1.04–5.60) and lower rates of transient atrial fibrillation (AF) (RR = 0.48, 95% CI 0.20–1.15). TC repair patients also had fewer pericardial effusions (RR = 0.27, 95% CI 0.05–1.54, I2 = 0.0%) and pneumothoraxes (RR = 0.18, 95% CI 0.04–0.80, I2 = 0.0%). However, TC repair results in more minor residual shunts (RR = 6.04, 95% CI 1.69–21.63 in favour of MIS, I2 = 39.0%). No differences were found for incidences of strokes (RR = 1.58, 95% CI 0.23–10.91, I2 = 19.3%), unexpected bleeding (RR = 0.44, 95% CI 0.19–1.04, I2 = 0.0%) and blood transfusion (RR = 0.39, 95% CI 0.09–1.59, I2 = 0.0%). Conclusions: MIS closure for ASD has similar outcomes compared to TC repair. However, the lack of randomised literature related to MIS versus TC repair for ASD closure warrants further evidence in the form of RCTs to further support these findings.

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The association between dietary inflammatory index and risk of central obesity in adults: An updated systematic review and meta-analysis

International Journal for Vitamin and Nutrition Research ◽

10.1024/0300-9831/a000648 ◽

2020 ◽

Vol 90 (5-6) ◽

pp. 535-552 ◽

Cited By ~ 2

Author(s):

Mahdieh Abbasalizad Farhangi ◽

Mahdi Vajdi

Keyword(s):

Systematic Review ◽

Observational Studies ◽

Central Obesity ◽

Assessment Tool ◽

Weighted Mean Difference ◽

Meta Analysis ◽

Dietary Factors ◽

Cross Sectional ◽

Inflammatory Status ◽

Obesity Indices

Abstract. Backgrounds: Central obesity, as a pivotal component of metabolic syndrome is associated with numerous co-morbidities. Dietary factors influence central obesity by increased inflammatory status. However, recent studies didn’t evaluate the association between central obesity and dietary inflammation index (DII®) that give score to dietary factors according to their inflammatory potential. In the current systematic review and meta-analysis, we summarized the studies that investigated the association between DII® with central obesity indices in the general populations. Methods: In a systematic search from PubMed, SCOPUS, Web of Sciences and Cochrane electronic databases, we collected relevant studies written in English and published until 30 October 2019. The population of included studies were apparently healthy subjects or individuals with obesity or obesity-related diseases. Observational studies that evaluated the association between DII® and indices of central obesity including WC or WHR were included. Results: Totally thirty-two studies were included; thirty studies were cross-sectional and two were cohort studies with 103071 participants. Meta-analysis of observational studies showed that higher DII® scores were associated with 1.81 cm increase in WC (Pooled weighted mean difference (WMD) = 1.813; CI: 0.785–2.841; p = 0.001). Also, a non-significant increase in the odds of having higher WC (OR = 1.162; CI: 0.95–1.43; p = 0.154) in the highest DII category was also observed. In subgroup analysis, the continent, dietary assessment tool and gender were the heterogeneity sources. Conclusion: The findings proposed that adherence to diets with high DII® scores was associated with increased WC. Further studies with interventional designs are necessary to elucidate the causality inference between DII® and central obesity indices.

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