Effectiveness of Current Perioperative Telemonitoring on Postoperative Outcome in Patients Undergoing Major Surgery: A Systematic Review of Controlled Trials

Effects of A Preoperative Exercise Training Program on Postoperative Pulmonary Complications and Exercise Capacity In Patients With Abdominal Cancer: A Systematic Review Protocol of Randomized Controlled Trials

10.21203/rs.3.rs-112781/v1 ◽

2020 ◽

Author(s):

Isabel Fialho Fontenele Garcia ◽

Vinicius Cavalheri ◽

Adriana Claudia Lunardi

Keyword(s):

Systematic Review ◽

Exercise Training ◽

Exercise Capacity ◽

Pulmonary Complications ◽

Major Surgery ◽

Controlled Trials ◽

Postoperative Pulmonary Complications ◽

Systematic Review Protocol ◽

Review Protocol ◽

Preoperative Exercise

Abstract Background Abdominal cancer surgeries have a high incidence of postoperative complications. One strategy to prevent postoperative complications is preoperative exercise training. There are no systematic reviews that have compared the effects of preoperative exercise training programs of different length, frequency and duration on pre and postoperative clinical outcomes as well as on length of hospital stay (LOS) and in-hospital and late mortality in people with abdominal cancer. Methods Searches for randomised controlled trials (RCTs) of preoperative exercise training for people undergoing major surgery for abdominal cancer will be conducted in Pubmed, EMBASE, PEDro (Physiotherapy Evidence Database) and the Cochrane Library. There will be no restrictions on the language or date of publication in the search. The primary outcomes of the systematic review will be incidence of postoperative pulmonary complications as well as post-intervention and postoperative exercise capacity. The risk of bias of included RCTs will be assessed using the PEDro scale. The quality of evidence will be rated using the GRADE system (Grading of Recommendations Assessment, Development and Evaluation). Subgroup analyzes will be conducted based on: intervention performed with or without supervision; types of exercises; and frequency and duration of the intervention. Discussion Our hypothesis is that preoperative exercise training will reduce the incidence of postoperative pulmonary complications in people undergoing major surgery for abdominal cancer by improving their preoperative exercise capacity. We will also explore the effects of the program on LOS and mortality. Systematic review registration: This systematic review protocol was registered with PROSPERO (Prospective International Register of Systematic Reviews) (number CRD42020199765).

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Immunonutrition in Patients with Pancreatic Cancer Undergoing Surgical Intervention: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Nutrients ◽

10.3390/nu12092798 ◽

2020 ◽

Vol 12 (9) ◽

pp. 2798

Author(s):

Fu-An Yang ◽

Yang-Ching Chen ◽

Cheng Tiong

Keyword(s):

Systematic Review ◽

Pancreatic Cancer ◽

Immune System ◽

Randomized Controlled Trials ◽

Meta Analysis ◽

Postoperative Outcome ◽

Categorical Variables ◽

Controlled Trials ◽

Continuous Variables ◽

Randomized Controlled

Immunonutrition is administered to improve the outcome of patients with pancreatic cancer undergoing surgery. However, its effect and mechanism of action remain unclear. Therefore, we conducted this systematic review and meta-analysis to assess its effects on postoperative outcome and the immune system. Randomized controlled trials (RCTs) were identified and data extracted by two reviewers independently from electronic databases from their inception to 31 October 2019. The result was expressed as the risk ratio (RR) for categorical variables and mean difference (MD) for continuous variables with 95% confidence intervals (CIs). Six RCTs published from 1999 and 2016, with a total of 368 patients, were included. The results revealed that immunonutrition significantly decreased the rate of infectious complications (RR = 0.47, 95% CI (0.23, 0.94), p = 0.03) and the length of hospital stay (MD = −1.90, 95% CI (−3.78, −0.02), p = 0.05) by modulating the immune system, especially in preoperative group in subgroup analysis. We therefore recommend that patients with pancreatic cancer undergoing surgery could take the advantage of immunonutrition, especially in the preoperative period.

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Effectiveness of current perioperative telemonitoring on postoperative outcome in patients undergoing major abdominal surgery: A systematic review of controlled trials

Journal of Telemedicine and Telecare ◽

10.1177/1357633x211047710 ◽

2021 ◽

pp. 1357633X2110477

Author(s):

Marjolein E Haveman ◽

Leonie T Jonker ◽

Hermie J Hermens ◽

Monique Tabak ◽

Jean-Paul PM de Vries

Keyword(s):

Systematic Review ◽

Abdominal Surgery ◽

Outcome Measures ◽

Major Abdominal Surgery ◽

Major Surgery ◽

Control Group ◽

Controlled Trials ◽

Clinical Patient ◽

Patient Reported ◽

Financial Outcome

Background Perioperative telemonitoring of patients undergoing major surgery might lead to improved postoperative outcomes. The aim of this systematic review is to evaluate the effectiveness of current perioperative telemonitoring interventions on postoperative clinical, patient-reported, and financial outcome measures in patients undergoing major surgery. Methods For this systematic review, PubMed, CINAHL, and Embase databases were searched for eligible articles published between January 1, 2009 and March 15, 2021. Studies were eligible as they described: (P) patients aged 18 years or older who underwent major abdominal surgery, (I) perioperative telemonitoring as intervention, (C) a control group receiving usual care, (O) any type of postoperative clinical, patient-reported, or financial outcome measures, and (S) an interventional study design. Results The search identified 2958 articles of which 10 were eligible for analysis, describing nine controlled trials of 2438 patients. Perioperative telemonitoring comprised wearable biosensors ( n = 3), websites ( n = 3), e-mail ( n = 1), and mobile applications ( n = 2). Outcome measures were clinical ( n = 8), patient-reported ( n = 5), and financial ( n = 2). Results show significant improvement of recovery time, stoma self-efficacy and pain in the early postoperative phase in patients receiving telemonitoring. Other outcome measures were not significantly different between the groups. Conclusion Evidence for the effectiveness of perioperative telemonitoring in major surgery is scarce. There is a need for good quality studies with sufficient patients while ensuring that the quality and usability of the technology and the adoption in care processes are optimal.

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