Surgical Treatment of Sprengel’s Deformity: A Systematic Review and Meta-Analysis

(1) Background: Sprengel’s deformity (SD) is a rare congenital anomaly caused by failure in the descent of the scapula. We aimed to systematically review the current literature reporting data from children undergoing surgery for SD, in order to explore the rate of success and complications of the different surgical techniques, possibly providing recommendations about the management of SD in children. (2) Methods: we electronically searched the literature from Ovid, MEDLINE and the Cochrane Library databases. Demographic data, surgical procedures, outcomes and complications were analyzed. We categorized surgical procedures into five groups. (3) Results: 41 articles met the inclusion criteria, showing a poor overall study quality; 674 patients (711 shoulders) were analyzed. Green’s and Woodward’s procedures, both aiming the scapular relocation in a more anatomical position, were the most commonly used techniques. We counted 168 adverse events (18 major complications). The best clinical and cosmetic results seem to be achieved when surgery is performed in children aged less than eight years. (4) Conclusions: this paper represents the first systematic review reporting qualitative and quantitative data about the surgical treatment of SD. Surgery for SD seems to be effective in increasing the shoulder’s range of motion and improving the cosmetic appearance in almost all cases, with a low rate of major complications.

Download Full-text

A systematic review of surgical procedures on thoracic myelopathy

Journal of Orthopaedic Surgery and Research ◽

10.1186/s13018-020-02081-y ◽

2020 ◽

Vol 15 (1) ◽

Author(s):

Shiqi Zhu ◽

Yu Wang ◽

Peng Yin ◽

Qingjun Su

Keyword(s):

Systematic Review ◽

Surgical Treatment ◽

Blood Loss ◽

Surgical Procedures ◽

Recovery Rate ◽

Cochrane Library ◽

Thoracic Myelopathy ◽

Posterior Decompression ◽

Number Of Patients ◽

Post Operation

Abstract Purpose The surgical treatment of thoracic myelopathy is still controversial and also a challenge for spine surgeons. Therefore, the objective of this study was to review the related literature on the surgical treatment of thoracic myelopathy and try to define treatment guidelines for spine surgeons on thoracic myelopathy. Methods Relevant literatures were searched based on the PubMed, EMBASE, and Cochrane Library between January 2008 and December 2018. Some data on the characteristics of patients were extracted, including number of patients, mean age, surgical procedures, blood loss, complications, and pre-/post-operation modified JOA score. Recovery rate was used to assess the effect of surgery outcome, and the safety was evaluated by blood loss and incidence of complications. Results Thirty-five studies met the inclusion criteria and were retrieved. A total of 2183 patients were included in our systematic review, with the average age of 55.2 years. There were 69.8% patients diagnosed as ossification of ligamentum flavum (OLF), 20.0% as ossification of posterior longitudinal ligament (OPLL), 9.3% as disk herniation (DH), and 0.9% as others including diffuse idiopathic skeletal hyperostosis (DISH) and ankylosing spondylitis (AS). The volume of blood loss was more in the treatment of circumferential decompression (CD) than posterior decompression (PD), and the incidence of complications was higher in CD (P < 0.05). The volume of blood loss in minimally invasive surgery (MIS) was lowest and the incidence of complications was 19.2%. Post-operation recovery rate was 0.49 in PD, 0.35 in CD, and 0.29 in MIS while the recovery rate was 0.54 in PD, 0.55 in CD, and 0.49 in MIS at the last follow-up. When focusing on the OLF specifically, incidence of complications in PD was much lower than CD, with less blood loss and higher recovery rate. Focusing on the OPLL specifically, incidence of complications in PD was much lower than CD, with less blood loss while there was no statistical difference in recovery rate between these two methods. Conclusions This systematic review showed that posterior decompression for thoracic myelopathy is safer and better than circumferential decompression according to the complication rate and surgical outcome. And we should also consider the location of compression before the operation.

Download Full-text

Using of Monofocal Intraocular Lenses Different Types for Cataract Surgery in Adult Patients: Systematic Review

Ophthalmology in Russia ◽

10.18008/1816-5095-2018-4-484-491 ◽

2019 ◽

Vol 15 (4) ◽

pp. 484-491

Author(s):

I. S. Krysanov ◽

V. S. Krysanova ◽

V. Yu. Ermakova

Keyword(s):

Systematic Review ◽

Clinical Trial ◽

Surgical Treatment ◽

Cataract Surgery ◽

Randomized Clinical Trial ◽

Meta Analysis ◽

Adult Patients ◽

Intraocular Lenses ◽

Cochrane Library ◽

The Cochrane Library

Objectives: to perfom analysis of the clinical efficacy and safety of using monofocal IOLs in the surgical treatment of cataracts in adult patients. Material and methods. In available sources (databases of the Cochrane Library and Medline) a search was conducted to evaluate the effectiveness and safety of using monofocal IOLs in cataract surgery in adult patients according to the PICO(S) regimen. A literature review was conducted in July 2018 for the keywords “intraocular lenses” and “cataract” using the following filters: clinical trial, randomized clinical trial, meta-analysis, systematic review (clinical trial, randomized clinical trial, meta-analysis, systematic review). Posting languages: English. Depth of search — 5 years. Last search date is July 27, 2018. Results. An initial search in the Medline database found 21,737 publications and 2157 in the Cochrane Library database. A total of 17,894 links were found. In a meta-analysis Zhao Y. et al., 2017, a comparison of the incidence of opacities of the posterior capsule (secondary cataract) after surgical treatment with the implantation of hydrophobic and hydrophilic IOLs was made. In multicenter retrospective cohort study Ursell P., et al, 2018 assessed the frequency of the Nd: YAG-laser capsulotomy for the treatment of secondary cataract which developed after the implantation of the IOL within the first 3 years after surgery. Conclusion. During the systematic review, the relationship between the incidence of complications (secondary cataracts) and the properties of the IOL material was found. The implantation of lenses from a hydrophobic material is associated with a lower incidence of secondary cataracts than the implantation of lenses from a hydrophilic material.

Download Full-text

Comparison of the Safety of Outpatient Cervical Disc Replacement With Inpatient Cervical Disc Replacement: A Systematic Review and Meta-Analysis

Global Spine Journal ◽

10.1177/2192568220959265 ◽

2020 ◽

pp. 219256822095926

Author(s):

Xiaofei Wang ◽

Yang Meng ◽

Hao Liu ◽

Ying Hong ◽

Beiyu Wang ◽

...

Keyword(s):

Systematic Review ◽

Prospective Studies ◽

Meta Analysis ◽

Demographic Data ◽

Operating Time ◽

Disc Replacement ◽

Current Evidence ◽

Cervical Disc ◽

Cochrane Library ◽

Cervical Disc Replacement

Study Design: A systematic review and meta-analysis. Objectives: Outpatient cervical disc replacement (CDR) has been performed with an increasing trend in recent years. However, the safety profile surrounding outpatient CDR remains insufficient. The present study systematically reviewed the current studies about outpatient CDR and performed a meta-analysis to evaluate the current evidence on the safety of outpatient CDR as a comparison with the inpatient CDR. Methods: We searched the PubMed, Embase, Web of Science, and Cochrane Library databases comprehensively up to April 2020. Patient demographic data, overall complication, readmission, returning to the operation room, operating time were analyzed with the Stata 14 software and R 3.4.4 software. Results: Nine retrospective studies were included. Patients underwent outpatient CDR were significantly younger (mean difference [MD] = −1.97; 95% CI −3.80 to −0.15; P = .034) and had lower prevalence of hypertension (OR = 0.68; 95% CI 0.53-0.87; P = .002) compared with inpatient CDR. The pooled prevalence of overall complication was 0.51% (95% CI 0.10% to 1.13%) for outpatient CDR. Outpatient CDR had a 59% reduction in risk of developing complications (OR = 0.41; 95% CI 0.18-0.95; P = .037). Outpatient CDR showed significantly shorter operating time (MD = −18.37; 95% CI −25.96 to −10.77; P < .001). The readmission and reoperation rate were similar between the 2 groups. Conclusions: There is a lack of prospective studies on the safety of outpatient CDR. However, current evidence shows outpatient CDR can be safely performed under careful patient selection. High-quality, large prospective studies are needed to demonstrate the generalizability of this study.

Download Full-text

Surgical Versus Nonsurgical Treatment for Acute Achilles Tendon Rupture A Systematic Review/Meta-Analysis

QJM ◽

10.1093/qjmed/hcaa059 ◽

2020 ◽

Vol 113 (Supplement_1) ◽

Author(s):

O A Elshazly ◽

A F Mohamed ◽

Y R A Mohamed

Keyword(s):

Systematic Review ◽

Achilles Tendon ◽

Tendon Rupture ◽

Meta Analysis ◽

Achilles Tendon Rupture ◽

Surgical Techniques ◽

Cochrane Library ◽

Wound Complications ◽

Rupture Rate ◽

Operative Repair

Abstract Background and Introduction Tendon Achilles injury affects 31.17 per 100000 per year, it has major impact on quality of life of affected patients, mostly active young patients. Different management options exist ranging from conservative treatment, to operative repair either open or percutaneous repair.no consensus has been reached on which treatment modality is preferred for each patient .in this study we systematically reviewed the literature for available evidence regarding management of tendon Achilles rupture. Aim of the Study to compare the two methods for treating Acute Achilles tendon rupture in a systematic review with meta-analysis and evaluate the functional outcomes of each methods. The objective is to perform a systematic review of overlapping meta-analysis regarding surgical versus non-surgical management of Acute Achilles tendon rupture to assist the decision makers in selecting their decision and provide intervention recommendations by the best available evidence. Methods This systematic review consisted of 5 studies, including a systematic search of the literature (PubMed, SCOPUS, and The Cochrane Library), selection of studies, extraction of study characteristics, assessment of methodological quality and bias. and extraction of data on clinical outcomes and their comparisons between different surgical groups. Results a total of 9 studies were included, 822 patients were extracted from the included studies. Of the 822 patients, 415 (50.4%) had undergone surgical intervention and 407 (49.6%) had received non-surgical treatment. The minimum follow-up duration was 12 months. The left Achilles tendon was relatively more prone to rupture. The interval from injury to treatment was within 2 to 14 days. Five 5 different surgical techniques were used; end to end, modified Kessler, augmented repair, Krackow type and interrupted circumferential stitch. Operative repair was found to significantly decrease rupture rate (risk ratio of 0.36, 95% CI 0.21-0.64; P = 0.0005) with higher risk of wound complications. No statistically significant difference between the two groups in functional outcome scores and range of motion. Conclusion We conclude that surgical technique lowers the risk of re-rupture rate but associated with higher complication rate which can be reduced by using the minimally invasive techniques. Multicenter randomized clinical trials are needed to obtain a high-quality level of evidence for the comparison between the different modified surgical techniques and the gap effect on making different decision of managements.

Download Full-text

Treatment of Laryngoceles: What Is the Progress over the Last Two Decades?

BioMed Research International ◽

10.1155/2014/819453 ◽

2014 ◽

Vol 2014 ◽

pp. 1-6 ◽

Cited By ~ 21

Author(s):

Karol Zelenik ◽

Lucia Stanikova ◽

Katarina Smatanova ◽

Michal Cerny ◽

Pavel Kominek

Keyword(s):

Case Reports ◽

Controlled Trial ◽

Meta Analysis ◽

Demographic Data ◽

Surgical Techniques ◽

Case Series ◽

Cochrane Library ◽

External Approach ◽

Randomized Controlled ◽

The Cochrane Library

Objectives. To review surgical techniques used in the treatment of laryngoceles over the last two decades and point out developments and trends.Materials and Methods. PubMed, the Cochrane Library, and the JBI Library of Systematic Reviews were searched using the term “laryngocele.” Demographic data, type of laryngocele, presence of a laryngopyocele, type of treatment and need for a tracheotomy were assessed.Results. Overall, data on 86 patients were analyzed, culled from 50 articles, of which 41 were case reports and 9 were case series. No single systematic review or meta-analysis or randomized controlled trial has been published on the topic. Altogether, 71 laryngoceles in 63 patients met the criteria for further analysis focusing on surgical treatment. An external approach was selected in 25/29 (86.2%) cases of combined laryngoceles. Microlaryngoscopic resection using a CO2laser was performed in three cases and endoscopic robotic surgery in one case. The majority of patients with an internal laryngocele, 31/42 (73.8%), were treated using the microlaryngoscopy approach.Conclusions. Microlaryngoscopy involving the use of a CO2laser has become the main therapeutic procedure for the treatment of internal laryngoceles during the past 20 years. An external approach still remains the main therapeutic approach for the treatment of combined laryngoceles.

Download Full-text

Surgical Treatment for Olfactory Groove Meningiomas: A Meta-Analysis of the Literature

10.21203/rs.3.rs-953431/v1 ◽

2021 ◽

Author(s):

Wei Wang ◽

Cong Chen ◽

Siqi Chen

Keyword(s):

Systematic Review ◽

Surgical Treatment ◽

Surgical Resection ◽

Fixed Effects ◽

Meta Analysis ◽

Csf Leak ◽

Cochrane Library ◽

Significant Heterogeneity ◽

Olfactory Groove ◽

Csf Leakage

Abstract Background Surgical resection of olfactory groove meningiomas (OGMs) is challenging and lots of surgical approaches can be chosen. We conducted a systematic review and meta-analysis of the studies investigating surgical resection of OGMs to better understand the surgical treatment of OGMs.Methods PubMed, Embase and Cochrane Library were used to search the studies reporting treatment outcomes of surgery for patients with OGMs. The final eligible studies were assessed using the Oxford Center for Evidence Based Medicine for level of evidence. Relevant parameters were extracted to perform descriptive and/or quantitative analyses.Results A total of 42 studies including 1673 patients were included in this systematic review (8 level 3 studies and 34 level 4 studies). Surgeries through transcranial approaches (TCAs) and endoscopic endonasal approach (EEA) were done on 1596 and 77 patients, respectively. Based on a random effects model, rates of gross total resection (GTR) and cerebrospinal fluid (CSF) leak were determined to be 92.4% (CI: 88.6-95.5%) and 5.9% (95% CI: 3.4-9%), respectively. The mortality following surgery was 1.6% (95% CI: 0.9-2.5%) under a fixed effects model. Through subgroup analyses, TCAs were found to be more favorable in GTR and CSF leakage compared to EEA. Besides, anterolateral TCA was associated with better control of CSF leakage than anterior TCA. Conclusion Surgical treatment is capable of achieving GTR in the vast majority of patients with OGMs and postoperative mortality is under well control. Transcranial approach allows a better chance of GTR and better control of CSF leak in comparison to EEA. In comparison to anterior TCA, anterolateral TCA is associated less mortality. However, low evidence level and significant heterogeneity of the included studies prevent the formation of more solid conclusions.

Download Full-text

Is acupuncture effective for knee osteoarthritis? A protocol for a systematic review and meta-analysis

BMJ Open ◽

10.1136/bmjopen-2021-052270 ◽

2022 ◽

Vol 12 (1) ◽

pp. e052270

Author(s):

Chuan-Yang Liu ◽

Jian-Feng Tu ◽

Myeong Soo Lee ◽

Ling-Yu Qi ◽

Fang-Ting Yu ◽

...

Keyword(s):

Systematic Review ◽

Knee Osteoarthritis ◽

Evidence Synthesis ◽

Meta Analysis ◽

Demographic Data ◽

Risk Of Bias ◽

Biomedical Literature ◽

Cochrane Library ◽

China National Knowledge Infrastructure ◽

Best Evidence Synthesis

IntroductionKnee osteoarthritis (KOA) is one of the leading causes of disability. The effectiveness of acupuncture for treating KOA remains controversial. This protocol describes the method of a systematic review and meta-analysis evaluating the effectiveness and safety of acupuncture for treating KOA.Methods and analysisFour English databases (PubMed, Embase, Cochrane Library databases and Web of Science) and four Chinese databases (China National Knowledge Infrastructure, Chinese Biomedical Literature Database, VIP Database for Chinese Technical Periodicals, and Wanfang) will be searched from the database inception to 1 September 2021. All randomised controlled trials related to acupuncture for KOA will be included. Extracted data will include publication details, basic information, demographic data, intervention details and patient outcomes. The primary outcome will be pain intensity. Risk of bias will be assessed using the Cochrane Collaboration’s tool for assessing risk of bias. Article selection, data extraction and risk of bias assessment will be performed in duplicate by two independent reviewers. If the meta-analysis is precluded, we will conduct a descriptive synthesis using a best-evidence synthesis approach. The strength of recommendations and quality of evidence will be assessed using the Grading of Recommendations Assessment Development and Evaluation working group methodology.Ethics and disseminationEthics approval is not required because individual patient data are not included. This protocol was registered in the international Prospective Register of Systematic Reviews on 25 February 2021. The systematic review and meta-analysis will be submitted for publication in a peer-reviewed journal. The findings will also be disseminated through conference presentations.Trial registration numberCRD42021232177.

Download Full-text

Bioaersols in orthopedic surgical procedures and implications for clinical practice in the times of COVID-19 pandemic: a protocol for systematic review and meta-analysis

10.1101/2020.07.19.20157511 ◽

2020 ◽

Author(s):

Siddhartha Sharma ◽

Rakesh John ◽

Deepak Neradi ◽

Sandeep Patel ◽

Mandeep Singh Dhillon

Keyword(s):

Systematic Review ◽

Surgical Procedures ◽

Meta Analysis ◽

Operating Rooms ◽

Risk Of Bias ◽

Cochrane Library ◽

Occupational Risk Factors ◽

Aerosol Generation ◽

Orthopedic Surgical Procedures ◽

Power Tools

Background Orthopedic surgical procedures involve a number of aerosol generating procedures; these include electrocautery, power instruments for bone cutting, burring and drilling, and tools for wound lavage. This assumes a great significance in the context of the current COVD-19 pandemic, as there are chances of aerosol-borne disease transmission in orthopedic surgical procedures. Hence, this systematic review and meta-analysis will be undertaken to assimilate and analyse the available evidence on bioaerosols in orthopedic surgical procedures and their significance with respect to SARS-CoV-2 virus transmission. Objectives To determine the characteristics (amount and/or density, size, infectivity, and spread etc.) of bioaerosols found in orthopaedic operating rooms (ORs) and to determine the characteristics of aerosols generated by different orthopaedic power tools and devices. Methods A systematic review and meta-analysis will be conducted. The PRISMA guidelines will be strictly followed. The primary search will be conducted on the PubMed, EMBASE, Scopus, Cochrane Library, medRxiv, bioRxix and Lancet preprint databases, using a well-defined search strategy. Any original research study (including cohort, case-control, case series, cadaveric studies and studies, animal models, laboratory based experimental studies) looking at aerosol generation in orthopedic surgical procedures, or aerosol generation by orthopaedic power tools and devices will included. Outcome measures will include characteristics (amount and/or density, size, infectivity, and spread etc.) of bioaerosols found in orthopaedic operating rooms (ORs) and those generated by various orthopaedics power tools and devices. Metanalysis using the random-effects model will be conducted to determined pooled estimates of the outcome variables. Heterogeneity will be assessed by the I2 test. Risk of bias will be assessed by the Risk of Bias in Studies estimating Prevalence of Exposure to Occupational risk factors (RoB-SPEO) tool. The overall strength of evidence will be assessed by the GRADE approach.

Download Full-text

Gastrointestinal recovery after surgery: protocol for a systematic review

BMJ Open ◽

10.1136/bmjopen-2021-054704 ◽

2021 ◽

Vol 11 (10) ◽

pp. e054704

Author(s):

Joshua G Kovoor ◽

Brandon Stretton ◽

Jonathan Henry W Jacobsen ◽

Aashray K Gupta ◽

Christopher D Ovenden ◽

...

Keyword(s):

Systematic Review ◽

Surgical Procedures ◽

Meta Analysis ◽

Clinical Care ◽

Scientific Journal ◽

Gastrointestinal Surgery ◽

Patient Characteristics ◽

Cochrane Library ◽

Registration Number ◽

Mean Time

IntroductionGastrointestinal recovery after surgery is of worldwide significance. Postoperative gastrointestinal dysfunction is multifaceted and known to represent a major source of postoperative morbidity, however, its significance to postoperative care across all surgical procedures is unknown. The complexity of postoperative gastrointestinal recovery is poorly defined within gastrointestinal surgery, and even less so outside this field. To inform the clinical care of surgical patients worldwide, this systematic review and meta-analysis will aim to characterise the duration of postoperative gastrointestinal recovery that can be expected across all surgical procedures and determine the associations between factors that may affect this.Methods and analysisMEDLINE, Embase, Cochrane Library and CINAHL will be searched for studies reporting the time to first postoperative passage of stool after any surgical procedure. We will screen records, extract data and assess risk of bias in duplicate. Forest plots will be constructed for time to postoperative gastrointestinal recovery, as assessed by various outcome measures. Because of potential heterogeneity, a random-effects model will be used throughout the meta-analysis. Funnel plots will be used to test for publication bias. Meta-regressions will be undertaken where the outcome is the mean time to first postoperative passage of stool, with potential predictors and confounders being patient characteristics, postoperative outcomes and surgical factors.Ethics and disseminationThis study will not involve human or animal subjects and, thus, does not require ethics approval. The outcomes will be disseminated via publication in peer-reviewed scientific journal(s) and presentations at scientific conferences.PROSPERO registration numberCRD42021256210.

Download Full-text

Treatment of posthemorrhagic ventricular dilation in preterm infants: a systematic review and meta-analysis of outcomes and complications

Journal of Neurosurgery Pediatrics ◽

10.3171/2015.3.peds14630 ◽

2015 ◽

Vol 16 (5) ◽

pp. 545-555 ◽

Cited By ~ 27

Author(s):

Jetan H. Badhiwala ◽

Chris J. Hong ◽

Farshad Nassiri ◽

Brian Y. Hong ◽

Jay Riva-Cambrin ◽

...

Keyword(s):

Systematic Review ◽

Premature Infants ◽

Meta Analysis ◽

Demographic Data ◽

External Ventricular Drain ◽

Neurodevelopmental Outcome ◽

Cochrane Library ◽

Ventricular Dilation ◽

Eligibility Criteria ◽

Posthemorrhagic Hydrocephalus

OBJECT The optimal clinical management of intraventricular hemorrhage (IVH) and posthemorrhagic ventricular dilation (PHVD)/posthemorrhagic hydrocephalus (PHH) in premature infants remains unclear. A common approach involves temporary treatment of hydrocephalus in these patients with a ventriculosubgaleal shunt (VSGS), ventricular access device (VAD), or external ventricular drain (EVD) until it becomes evident that the patient needs and can tolerate permanent CSF diversion (i.e., ventriculoperitoneal shunt). The present systematic review and meta-analysis aimed to provide a robust and comprehensive summary of the published literature regarding the clinical outcomes and complications of these 3 techniques as temporizing measures in the management of prematurity-related PHVD/PHH. METHODS The authors searched MEDLINE, EMBASE, CINAHL, Google Scholar, and the Cochrane Library for studies published through December 2013 on the use of VSGSs, VADs, and/or EVDs as temporizing devices for the treatment of hydrocephalus following IVH in the premature neonate. Data pertaining to patient demographic data, study methods, interventions, and outcomes were extracted from eligible articles. For each of the 3 types of temporizing device, the authors performed meta-analyses examining 6 outcomes of interest, which were rates of 1) obstruction; 2) infection; 3) arrest of hydrocephalus (i.e., permanent shunt independence); 4) mortality; 5) good neurodevelopmental outcome; and 6) revision. RESULTS Thirty-nine studies, representing 1502 patients, met eligibility criteria. All of the included articles were observational studies; 36 were retrospective and 3 were prospective designs. Nine studies (n = 295) examined VSGSs, 24 (n = 962) VADs, and 9 (n = 245) EVDs. Pooled rates of outcome for VSGS, VAD, and EVD, respectively, were 9.6%, 7.3%, and 6.8% for obstruction; 9.2%, 9.5%, and 6.7% for infection; 12.2%, 10.8%, and 47.3% for revision; 13.9%, 17.5%, and 31.8% for arrest of hydrocephalus; 12.1%, 15.3%, and 19.1% for death; and 58.7%, 50.1%, and 56.1% for good neurodevelopmental outcome. CONCLUSIONS This study provides robust estimates of outcomes for the most common temporizing treatments for IVH in premature infants. With few exceptions, the range of outcomes was similar for VSGS, VAD, and EVD.

Download Full-text