scholarly journals Impact on ovarian reserve after minimally invasive single-port laparoscopic ovarian cystectomy in patients with benign ovarian cysts: A systematic review and meta-analysis

2021 ◽  
Author(s):  
Eleni Tsiampa ◽  
Eleftherios Spartalis ◽  
Gerasimos Tsourouflis ◽  
Dimitrios Dimitroulis ◽  
Nikolaos Nikiteas
Keyword(s):  
Systematic Review ◽  
Postoperative Complications ◽  
Blood Loss ◽  
Ovarian Reserve ◽  
Operative Time ◽  
Single Port ◽  
Meta Analysis ◽  
Ovarian Cysts ◽  
Ovarian Cystectomy ◽  
Reduced Port

Background/Aim: The purpose of this article is to review the published literature on single-port laparoscopic (SPL) ovarian cystectomy and to assess whether the reduced port number affects the ovarian reserve in comparison with the conventional multiport laparoscopic (MPL) ovarian cystectomy. Materials and methods: Serum anti-Müllerian hormone (AMH) had been proposed as the most accurate marker of ovarian reserve. A review of the current literature was performed based on the preoperative and postoperative AMH after SPL and MPL ovarian cystectomy in adult patients with benign ovarian cysts. Results: Ovarian cystectomy causes a non-statistically significant reduction in AMH levels four weeks postoperatively in the SPL group compared to MPL group[MD=0.11, 95%CI (-0.01, 0.24), p=0.07] . Operative time was significantly longer and blood loss was significantly higher in SPL group. No difference was found to major or overall postoperative complications between the two groups Conclusion: SPL cystectomy recommended as a safe surgical choice for patients who want to preserve their fertility.

Effects of Preoperative Iodine Administration on Thyroidectomy for Hyperthyroidism: A Systematic Review and Meta-analysis

2019 ◽  
Vol 160 (6) ◽  
pp. 993-1002 ◽  
Author(s):  
Chung-Hsin Tsai ◽  
Po-Sheng Yang ◽  
Jie-Jen Lee ◽  
Tsang-Pai Liu ◽  
Chi-Yu Kuo ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Blood Loss ◽  
Operative Time ◽  
Meta Analysis ◽  
Thyroid Volume ◽  
Vocal Cord Palsy ◽  
Significant Heterogeneity ◽  
Intraoperative Blood Loss ◽  
Significant Difference ◽  
And Control

Objective The current guidelines recommend that potassium iodide be given in the immediate preoperative period for patients with Graves’ disease who are undergoing thyroidectomy. Nonetheless, the evidence behind this recommendation is tenuous. The purpose of this study is to clarify the benefits of preoperative iodine administration from published comparative studies. Data Sources We searched PubMed, Embase, Cochrane, and CINAHL from 1980 to June 2018. Review Methods Studies were included that compared preoperative iodine administration and no premedication before thyroidectomy. For the meta-analysis, studies were pooled with the random-effects model. Results A total of 510 patients were divided into the iodine (n = 223) and control (n = 287) groups from 9 selected studies. Preoperative iodine administration was significantly associated with decreased thyroid vascularity and intraoperative blood loss. Significant heterogeneity was present among studies. We found no significant difference in thyroid volume or operative time. Furthermore, the meta-analysis showed no difference in the risk of postoperative complications, including vocal cord palsy, hypoparathyroidism/hypocalcemia, and hemorrhage or hematoma after thyroidectomy. Conclusion Preoperative iodine administration decreases thyroid vascularity and intraoperative blood loss. Nonetheless, it does not translate to more clinically meaningful differences in terms of operative time and postoperative complications.

scholarly journals Evaluating robotic pedicle screw placement against conventional modalities: a systematic review and network meta-analysis

2022 ◽  
Vol 52 (1) ◽  
pp. E10
Keyword(s):  
Systematic Review ◽  
Blood Loss ◽  
Operative Time ◽  
Meta Analysis ◽  
Screw Placement ◽  
Intraoperative Blood Loss ◽  
Robot Assisted ◽  
Training Requirements ◽  
3D Fluoroscopy ◽  
Placement Accuracy

OBJECTIVE Several approaches have been studied for internal fixation of the spine using pedicle screws (PSs), including CT navigation, 2D and 3D fluoroscopy, freehand, and robotic assistance. Robot-assisted PS placement has been controversial because training requirements, cost, and previously unclear benefits. This meta-analysis compares screw placement accuracy, operative time, intraoperative blood loss, and overall complications of PS insertion using traditional freehand, navigated, and robot-assisted methods. METHODS A systematic review was performed of peer-reviewed articles indexed in several databases between January 2000 and August 2021 comparing ≥ 2 PS insertion methods with ≥ 10 screws per treatment arm. Data were extracted for patient outcomes, including PS placement, misplacement, and accuracy; operative time, overall complications, intraoperative blood loss, postoperative hospital length of stay, postoperative Oswestry Disability Index (ODI) score, and postoperative visual analog scale (VAS) score for back pain. Risk of bias was assessed using the Newcastle-Ottawa score and Cochrane tool. A network meta-analysis (NMA) was performed to estimate PS placement accuracy as the primary outcome. RESULTS Overall, 78 studies consisting of 6262 patients and > 31,909 PSs were included. NMA results showed that robot-assisted and 3D-fluoroscopy PS insertion had the greatest accuracy compared with freehand (p < 0.01 and p < 0.001, respectively), CT navigation (p = 0.02 and p = 0.04, respectively), and 2D fluoroscopy (p < 0.01 and p < 0.01, respectively). The surface under the cumulative ranking (SUCRA) curve method further demonstrated that robot-assisted PS insertion accuracy was superior (S = 0.937). Optimal screw placement was greatest in robot-assisted (S = 0.995) placement, and misplacement was greatest with freehand (S = 0.069) approaches. Robot-assisted placement was favorable for minimizing complications (S = 0.876), while freehand placement had greater odds of complication than robot-assisted (OR 2.49, p < 0.01) and CT-navigation (OR 2.15, p = 0.03) placement. CONCLUSIONS The results of this NMA suggest that robot-assisted PS insertion has advantages, including improved accuracy, optimal placement, and minimized surgical complications, compared with other PS insertion methods. Limitations included overgeneralization of categories and time-dependent effects.

Impact on Ovarian Reserve after Minimally Invasive Single-Port Laparoscopic Ovarian Cystectomy in Patients with Benign Ovarian Cysts: A Review of the Literature

2020 ◽  
Vol 3 (1) ◽  
Author(s):  
Tsiampa Eleni ◽  
Spartalis Eleftherios ◽  
Tsiampas Konstantinos ◽  
Tsourouflis Gerasimos ◽  
Dimitroulis Dimitrios ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Ovarian Reserve ◽  
Single Port ◽  
Ovarian Cysts ◽  
Review Of The Literature ◽  
Ovarian Cystectomy

scholarly journals Robotic versus laparoscopic splenectomy: a systematic review of perioperative outcomes

2021 ◽  
Author(s):  
Anantha Shreepad Bhat ◽  
Alexia Farrugia ◽  
Qazi Rahim Muhammad ◽  
Viera Kulikova ◽  
Gabriele Marangoni ◽  
...  
Keyword(s):  
Systematic Review ◽  
Postoperative Complications ◽  
Length Of Stay ◽  
Blood Loss ◽  
Laparoscopic Splenectomy ◽  
Open Surgery ◽  
Operative Time ◽  
Adult Population ◽  
Perioperative Outcomes ◽  
Significant Difference

Summary Background Elective splenectomy has various indications and can be performed open or minimally invasively. Laparoscopic splenectomy (LS) is popular but has limitations. Some studies suggest potential superiority of robotic splenectomy (RS) over LS. As such, we conducted a systematic review to determine whether RS has greater positive perioperative outcomes in comparison to LS in the adult population. Methods We searched for studies that reported perioperative outcomes and compared RS to LS in the adult population. Outcome measures were operative time, conversion to open surgery, postoperative complications, mortality, length of stay, blood loss and cost analysis. A simple, unpaired two-tailed student’s t‑test was used to compare outcomes between the RS and LS patient groups. Results After full-text analysis of 47 papers, three studies met the inclusion criteria. The studies involved 72 patients (28 in the RS group, 44 in the LS group). RS demonstrated no significantly reduced blood loss in comparison to LS (p = 0.13). RS had no cases converting to open surgery and no postoperative complications in comparison to LS. No significant difference was found between RS and LS with regards to LOS (p = 0.89) and cost benefit (p = 0.74). RS had a higher operative time in comparison to LS which was not statistically significant (p = 0.45). Conclusion The RS approach may be associated with lower blood loss and a lower risk of conversions. There was no statistical difference between RS and LS with regards to length of stay (LOS) and cost. RS takes longer to perform in comparison to LS.

scholarly journals 723 Neuroendoscopy versus Craniotomy in Basal Ganglia Haemorrhage: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
T K Tan ◽  
J Merola ◽  
M Zaben ◽  
W Gray ◽  
P Leach
Keyword(s):  
Systematic Review ◽  
Basal Ganglia ◽  
Mortality Rate ◽  
Blood Loss ◽  
Hospital Stay ◽  
Operative Time ◽  
Meta Analysis ◽  
Length Of Hospital Stay ◽  
Endoscopic Approach ◽  
Intraoperative Blood Loss

Abstract Aim Basal ganglia haemorrhage (BGH) is the most common type of intracerebral bleed with high morbidity and mortality rate. The efficacy between craniotomy and endoscopic approach in BGH is still debatable and advancement in minimally invasive technique has made endoscopic approach the preferred option. The aim of this systematic review and meta-analysis was to evaluate the outcomes of craniotomy and endoscopic approach in BGH. Method Databases of PubMed, EMBASE, MEDLINE and CENTRAL were systematically searched from its inception until December 2020. All randomized clinical trials and observational studies comparing craniotomy versus endoscopic approach in BGH were included. Results Twelve studies enrolling 1297 patients (craniotomy:675, endoscopy:632) were included for qualitative and quantitative analysis. Endoscopic approach was associated with significantly lower postoperative mortality (OR:0.35, P &lt; 0.00001), higher haematoma evacuation rate (MD:4.95, P = 0.0002), shorter operative time (MD:-117.03, P &lt; 0.00001), lesser intraoperative blood loss (MD:-328.47, P &lt; 0.00001), higher postoperative Glasgow Coma Scale (GCS) (MD:1.14, P = 0.01), higher postoperative Glasgow Outcome Scale (GOS) (MD:0.44, P = 0.05), shorter length of hospital stay (MD:-2.90, P &lt; 0.00001), lower complication rate (OR:0.30, P = 0.0004), lower infection rate (OR:0.29, P &lt; 0.00001) and lower modified Rankin Scale (mRS) (MD:-0.57, P = 0.004) compared to craniotomy. No significant difference was detected in reoperation, intracranial infection, re-bleeding. Conclusions The best available evidence suggest that endoscopic approach has better outcomes in mortality rate, operative time, haematoma evacuation rate, intraoperative blood loss, length of hospital stay, mRS, postoperative GCS and GOS compared with craniotomy in the management of BGH. However, there is a need for high quality randomised controlled trials with large sample size for definite conclusions.

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