Distal subtotal resection and gastrectomy in the treatment of patients with gastric cancer. A critical review of meta-analyses

The purpose of the work is to study the evidence base by comparing the results of distal subtotal resection and gastrectomy with D2 lymphadenectomy in patients with distal gastric cancer. Materials and methods. Three meta-analyses were selected during the systematic review process. Their validity assessment and critical analysis were carried out using the recommendations of the Cochrane community. Results. The greatest heterogeneity was noted in calculations of the frequency of postoperative complications. This indicator ranges from 1.1 % to 22 %. Postoperative mortality ranges from 0.6 % to 2.9 %. The overall five-year survival rate after gastrectomy is 49.6 %–53.9 %, after distal subtotal resection — 55.9 %–63.9 %. A large number of systematic biases in completed meta-analyses reduces the degree of reliability of the evidence base in this matter to the level 2 of evidence. Conclusion. Further evidence-based level 1 studies are needed to compare the results of distal subtotal resection and gastrectomy in patients with distal gastric cancer.

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Modified Devine Exclusion for Unresectable Distal Gastric Cancer in Symptomatic Patients

Case Reports in Gastroenterology ◽

10.1159/000452759 ◽

2017 ◽

Vol 11 (1) ◽

pp. 9-16 ◽

Cited By ~ 3

Author(s):

María Carmen Fernández-Moreno ◽

Roberto Martí-Obiol ◽

Fernando López ◽

Joaquín Ortega

Keyword(s):

Gastric Cancer ◽

Oral Tolerance ◽

Outlet Obstruction ◽

Postoperative Mortality ◽

Palliative Surgery ◽

Alternative Methods ◽

Blood Transfusions ◽

Safe Procedure ◽

Severe Anemia ◽

Distal Gastric Cancer

Background: In patients with outlet obstruction syndrome and/or severe anemia secondary to unresectable gastric cancer (GC), partial stomach-partitioning gastrojejunostomy, or modified Devine exclusion, is a surgical alternative. Methods: A retrospective study was conducted on patients with unresectable distal GC treated with modified Devine exclusion as palliative surgery between February 2005 and December 2015. It consisted of a series of 10 patients with outlet obstruction syndrome and/or severe anemia. The outcomes of this technique were based on oral tolerance, blood transfusions, postoperative complications, and survival. Results: Early oral tolerance and a low rate of blood transfusions were observed postoperatively. There was no postoperative mortality and a very low complication rate without anastomotic leakage. Median survival was 9 months. Conclusions: Partial stomach-partitioning gastrojejunostomy is a safe procedure for unresectable GC which can improve the quality of life of these patients.

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Difference in surgical outcomes of rectal cancer by study design: meta-analyses of randomized clinical trials, case-matched studies, and cohort studies

BJS Open ◽

10.1093/bjsopen/zraa067 ◽

2021 ◽

Vol 5 (2) ◽

Author(s):

N Hoshino ◽

T Sakamoto ◽

K Hida ◽

Y Takahashi ◽

H Okada ◽

...

Keyword(s):

Rectal Cancer ◽

Laparoscopic Surgery ◽

Robotic Surgery ◽

Cohort Studies ◽

Anastomotic Leakage ◽

Study Design ◽

Randomized Clinical Trials ◽

Postoperative Mortality ◽

Resection Margins ◽

Meta Analyses

Abstract Background RCTs are considered the standard in surgical research, whereas case-matched studies and propensity score matching studies are conducted as an alternative option. Both study designs have been used to investigate the potential superiority of robotic surgery over laparoscopic surgery for rectal cancer. However, no conclusion has been reached regarding whether there are differences in findings according to study design. This study aimed to examine similarities and differences in findings relating to robotic surgery for rectal cancer by study design. Methods A comprehensive literature search was conducted using PubMed, Scopus, and Cochrane CENTRAL to identify RCTs, case-matched studies, and cohort studies that compared robotic versus laparoscopic surgery for rectal cancer. Primary outcomes were incidence of postoperative overall complications, incidence of anastomotic leakage, and postoperative mortality. Meta-analyses were performed for each study design using a random-effects model. Results Fifty-nine articles were identified and reviewed. No differences were observed in incidence of anastomotic leakage, mortality, rate of positive circumferential resection margins, conversion rate, and duration of operation by study design. With respect to the incidence of postoperative overall complications and duration of hospital stay, the superiority of robotic surgery was most evident in cohort studies (risk ratio (RR) 0.83, 95 per cent c.i. 0.74 to 0.92, P < 0.001; mean difference (MD) –1.11 (95 per cent c.i. –1.86 to –0.36) days, P = 0.004; respectively), and least evident in RCTs (RR 1.12, 0.91 to 1.38, P = 0.27; MD –0.28 (–1.44 to 0.88) days, P = 0.64; respectively). Conclusion Results of case-matched studies were often similar to those of RCTs in terms of outcomes of robotic surgery for rectal cancer. However, case-matched studies occasionally overestimated the effects of interventions compared with RCTs.

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Primary Crime Prevention Apps: A Typology and Scoping Review

Trauma Violence & Abuse ◽

10.1177/1524838020985560 ◽

2021 ◽

pp. 152483802098556

Author(s):

Mark A. Wood ◽

Stuart Ross ◽

Diana Johns

Keyword(s):

Crime Prevention ◽

Scoping Review ◽

Decision Aid ◽

English Language ◽

Web Of Science ◽

Evidence Base ◽

Smartphone Apps ◽

Initial Sample ◽

Language Research ◽

Meta Analyses

In the last decade, an array of smartphone apps have been designed to prevent crime, violence, and abuse. The evidence base of these apps has, however, yet to analyzed systematically. To rectify this, the aims of this review were (1) to establish the extent, range, and nature of research into smartphone apps with a primary crime prevention function; (2) to locate gaps in the primary crime prevention app literature; and (3) to develop a typology of primary crime prevention apps. Employing a scoping review methodology and following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, studies were identified via Web of Science, EBSCOhost, and Google Scholar. We included English-language research published between 2008 and 2020 that examined smartphone applications designed explicitly for primary crime prevention. Sixty-one publications met our criteria for review, out of an initial sample of 151 identified. Our review identified six types of crime prevention app examined in these publications: self-surveillance apps, decision aid apps, child-tracking apps, educational apps, crime-mapping/alert apps, and crime reporting apps. The findings of our review indicate that most of these forms of primary crime prevention apps have yet to be rigorously evaluated and many are not evidence-based in their design. Consequently, our review indicates that recent enthusiasm over primary crime prevention apps is not supported by an adequate evidence base.

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Polyphenols and Cognition In Humans: An Overview of Current Evidence from Recent Systematic Reviews and Meta-Analyses

Brain Plasticity ◽

10.3233/bpl-200111 ◽

2020 ◽

pp. 1-15

Author(s):

Daniel Joseph Lamport ◽

Claire Michelle Williams

Keyword(s):

Systematic Reviews ◽

Evidence Base ◽

Epidemiological Studies ◽

Cognitive Outcome ◽

Current Evidence ◽

Duration Of Treatment ◽

Current Evidence Base ◽

Cognitive Benefits ◽

Meta Analyses ◽

The Impact

There is increasing interest in the impact of dietary influences on the brain throughout the lifespan, ranging from improving cognitive development in children through to attenuating ageing related cognitive decline and reducing risk of neurodegenerative diseases. Polyphenols, phytochemicals naturally present in a host of fruits, vegetables, tea, cocoa and other foods, have received particular attention in this regard, and there is now a substantial body of evidence from experimental and epidemiological studies examining whether their consumption is associated with cognitive benefits. The purpose of this overview is to synthesise and evaluate the best available evidence from two sources, namely meta-analyses and systematic reviews, in order to give an accurate reflection of the current evidence base for an association between polyphenols and cognitive benefits. Four meta-analyses and thirteen systematic reviews published between 2017–2020 were included, and were categorised according to whether they reviewed specific polyphenol-rich foods and classes or all polyphenols. A requirement for inclusion was assessment of a behavioural cognitive outcome in humans. A clear and consistent theme emerged that whilst there is support for an association between polyphenol consumption and cognitive benefits, this conclusion is tentative, and by no means definitive. Considerable methodological heterogeneity was repeatedly highlighted as problematic such that the current evidence base does not support reliable conclusions relating to efficacy of specific doses, duration of treatment, or sensitivity in specific populations or certain cognitive domains. The complexity of multiple interactions between a range of direct and indirect mechanisms of action is discussed. Further research is required to strengthen the reliability of the evidence base.

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A Systematic Review of Meta-Analyses in Special Education: Exploring the Evidence Base for High-Leverage Practices

Remedial and Special Education ◽

10.1177/07419325211063491 ◽

2021 ◽

pp. 074193252110634

Author(s):

Gena Nelson ◽

Sara Cothren Cook ◽

Kary Zarate ◽

Sarah R. Powell ◽

Daniel M. Maggin ◽

...

Keyword(s):

Systematic Review ◽

Special Education ◽

Students With Disabilities ◽

Special Education Teachers ◽

Evidence Base ◽

Future Research ◽

Evidence Based Practices ◽

Intensive Instruction ◽

Disability Categories ◽

Meta Analyses

It is crucial that special education teachers are equipped with the knowledge and skills necessary to improve outcomes for students with disabilities. Despite federal legislation and efforts of the field to identify and disseminate evidence-based practices for students with disabilities, it is uncertain whether all special education teachers provide instruction based on the best available research. To better prepare special education teachers, McLeskey et al. proposed 22 high-leverage practices (HLPs). We conducted this systematic review of meta-analyses to provide an initial investigation of the experimental evidence reporting on the effectiveness of the HLPs for students with, or at risk for, a disability. Results indicated the largest amount of evidence from meta-analyses related to intensive instruction, explicit instruction, and social skills, with few meta-analyses reporting on collaboration and assessment. The results highlighted disproportional evidence according to disability categories. Implications for future research, practice, and teacher education are discussed.

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Phẫu thuật nội soi 3D cắt bán phần xa dạ dày trong điều trị ung thư dạ dày

Journal of Clinical Medicine- Hue Central Hospital ◽

10.38103/jcmhch.2021.74.3 ◽

2021 ◽

Author(s):

Hai Thanh Phan

Keyword(s):

Gastric Cancer ◽

Blood Loss ◽

Operative Time ◽

Distal Gastrectomy ◽

Three Dimensional ◽

Oncologic Outcome ◽

Intraoperative Blood Loss ◽

3D Laparoscopy ◽

Distal Gastric Cancer ◽

The Mean

TÓM TẮT Đặt vấn đề: Những nghiên cứu gần đây cho thấy phẫu thuật nội soi với kỹ thuật 3D (three - dimensional) đã mang lại nhiều thuận lợi trong điều trị ung thư dạ dày khi so sánh với màn hình 2D truyền thống. Vì vậy chúng tôi thực hiện nghiên cứu này với mục đích đánh giá tính an toàn, kết quả ngắn hạn và kết quả ung thư học của phẫu thuật nội soi 3D trong điều trị ung thư phần xa dạ dày. Phương pháp nghiên cứu: Thực hiện nghiên cứu tiến cứu trên 37 bệnh nhân cắt phần xa dạ dày kèm nạo vét hạch điều trị ung thư dạ dày bằng phẫu thuật nội soi kỹ thuật 3D tại Khoa Ngoại nhi - cấp cứu bụng, Bệnh viện Trung Ương Huế từ 03/2018 đến 09/2021. Kết quả: Phẫu thuật nội soi 3D được thực hiện ở tất cả 37 bệnh nhân, không có trường hợp nào chuyển mổ mở. Thời gian phẫu thuật trung bình là 69,86 ± 20,46 phút, lượng máu mất trong mổ trung bình là 171,22 ± 15,47 ml, số hạch vét được trung bình là 20,49 ± 4,11 hạch và thời gian nằm viện sau phẫu thuật trung bình là 10 ngày (6 - 26 ngày). Tỷ lệ biến chứng là 8,1 % với 1 trường hợp (2,7%) dò mỏm tá tràng, không có trường hợp nào tử vong sớm sau mổ. Tỉ lệ sống còn sau 1 năm là 87,27% và sau 3 năm là 83,31%. Kết luận: Áp dụng phẫu thuật nội soi 3D trong cắt phần xa dạ dày có thể thực hiện an toàn và khả thi. Giúp giảm đáng kể thời gian mổ, lượng máu mất trong mổ và đảm bảo được nguyên tắc an toàn về ung thư học. ABSTRACT EFFICACY USING THREE - DIMENSIONAL LAPAROSCOPY IN THE TREATMENT OF DISTAL GASTRIC CANCER Background: Recent studies have supported that three - dimensional (3D) laparoscopy has advantages in treating gastric cancer compared with conventional two - dimensional (2D) screens. This study investigated the safety, short - term efficacy, and oncological outcome of three - dimensional (3D) laparoscopic distal gastric cancer surgery. Materials and Methods: We prospectively analyzed the clinical data from 37 patients treated with 3D laparoscopic systemic lymphadenectomy for distal gastric cancer at the Hue Central Hospital from March 2018 to September 2021. The effects on operative time, intraoperative blood loss, the number of lymph nodes removed, postoperative recovery time, complications, and oncologic outcome were analyzed. Results: Three - dimensional (3D) laparoscopic distal gastrectomy was successfully carried out in 37 patients. The mean operative time was 69,86 ± 20,46 minutes, mean intraoperative blood loss was 171,22 ± 15,47 ml, the number of harvested lymph nodes was 20,49 ± 4,11, and the mean postoperative hospital stay was 10 (6 - 26 days). The incidence of postoperative complications was 8,1%, with 1 case of duodenal stump fistula. The one - year overall survival rate was 87,27%, and the three - year overall survival rate was 83,31%. Conclusions: 3D laparoscopy distal gastrectomy could be performed safely and feasibly. They reducethe operative time and intraoperative blood loss in distal gastrectomy with a good oncologic outcome. Keywords: Laparoscopic gastrectomy, D2 lymphadenectomy, 3D laparoscopy

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The effectiveness of probation supervision towards reducing reoffending: A Rapid Evidence Assessment

Probation Journal ◽

10.1177/0264550518796275 ◽

2018 ◽

Vol 65 (4) ◽

pp. 407-428 ◽

Cited By ~ 2

Author(s):

Andrew Smith ◽

Kim Heyes ◽

Chris Fox ◽

Jordan Harrison ◽

Zsolt Kiss ◽

...

Keyword(s):

Evidence Base ◽

Empirical Literature ◽

Future Research ◽

What Works ◽

Research Designs ◽

The Usa ◽

Probation Supervision ◽

Methodological Considerations ◽

Meta Analyses

In response to the lack of universal agreement about ‘What Works’ in probation supervision (Trotter, 2013) we undertook a Rapid Evidence Assessment of the empirical literature. Our analysis of research into the effect of probation supervision reducing reoffending included 13 studies, all of which employed robust research designs, originating in the USA, UK, Canada and Australia, published between 2006 and 2016. We describe the papers included in our review, and the meta-analyses of their findings. Overall, we found that the likelihood of reoffending was shown to be lower for offenders who had been exposed to some type of supervision. This finding should be interpreted cautiously however, given the heterogeneity of the studies. We suggest future research and methodological considerations to develop the evidence base concerning the effectiveness of probation supervision.

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ADDUCTOR POLLICIS MUSCLE THICKNESS AND PREDICTION OF POSTOPERATIVE MORTALITY IN PATIENTS WITH STOMACH CANCER

ABCD Arquivos Brasileiros de Cirurgia Digestiva (São Paulo) ◽

10.1590/0102-672020180001e1340 ◽

2018 ◽

Vol 31 (1) ◽

Cited By ~ 6

Author(s):

Aline Kirjner POZIOMYCK ◽

Oly Campos CORLETA ◽

Leandro Totti CAVAZZOLA ◽

Antonio Carlos WESTON ◽

Edson Braga LAMEU ◽

...

Keyword(s):

Gastric Cancer ◽

Stomach Cancer ◽

Nutritional Assessment ◽

Postoperative Mortality ◽

Muscle Thickness ◽

Adductor Pollicis ◽

Dominant Hand ◽

Adductor Pollicis Muscle ◽

Risk Of Death ◽

Muscle Compartment

ABSTRACT Background: Malnutrition is very prevalent in patients with gastric cancer and increases the risk of morbidity and mortality. Adductor pollicis muscle thickness (APMT) appears as an important objective, quick, inexpensive and noninvasive measure to assess the muscle compartment Aim: To compare APMT and other nutritional assessment methods and to correlate these methods with postoperative mortality Methods: Forty-four patients, 29 men and 15 women, mean age of 63±10.2 and ranging from 34-83 years, who underwent nine (20.5%) partial and 34 (77.3%) total gastrectomies due to stomach cancer (stage II to IIIa) were preoperatively assessed by Patient Generated Subjective Global Assessment (PG-SGA), anthropometry and laboratorial profile Results: APMT better predicted death (p<0.001) on both, dominant and non-dominant hand, and well correlated with albumin (p=0.039) and PG-SGA (p=0.007) Conclusion: APMT clearly allowed to determine malnutrition and to predict risk of death in patients with gastric cancer.

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Systematic review of evidence underpinning non-pharmacological therapies in dementia

Australian Health Review ◽

10.1071/ah16212 ◽

2018 ◽

Vol 42 (4) ◽

pp. 361 ◽

Cited By ~ 3

Author(s):

Richard Olley ◽

Andrea Morales

Keyword(s):

Systematic Review ◽

Sleep Disturbances ◽

Research Effort ◽

Evidence Base ◽

Pharmacological Therapy ◽

Sufficient Evidence ◽

Behavioural Treatment ◽

Significant Research ◽

Research Gap ◽

Meta Analyses

Objective Dementia is one of the most common illnesses worldwide, and is one of the most important causes of disability in older people. Currently, dementia affects over 35 million people around the globe. It is expected that this number will increase to 65.7 million by 2030. Early detection, diagnosis and treatment to control the principal behaviour symptoms may help reduce these numbers and delay the progression to more advanced and dangerous stages of this disorder with resultant increase quality of life for those affected. The main goal of the present systematic literature review was to examine contemporary evidence relating to non-pharmacological therapy in the treatment of dementia. Methods To achieve the study goal, the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement was used. Results This study identified the five most common behaviours in patients with dementia as aggression, wandering, agitation, apathy and sleep disturbances. Two non-pharmacological therapies were the most studied treatment: music therapy and aromatherapy. Ten other non-pharmacological therapies were also identified, but these lack a sufficient evidence-base. Conclusion Although all the therapies identified could be used as part of the treatment of behavioural symptoms, there is insufficient evidence relating to the indications, appropriate use and effectiveness of these therapies to apply in each behavioural treatment. Thus, the present study has demonstrated a significant research gap. What is known about the topic? Despite the widespread use of many different types of therapies, there is limited evidence regarding the efficacy of non-pharmaceutical therapies deployed in the management of behaviours of concern manifested by some people who suffer with dementia in all its forms. What does this paper add? This systematic review examines contemporary evidence from the literature to determine whether there is an evidence base available that would underpin the use of these therapies. This report on a PRISMA systematic review of the available literature demonstrates that only two therapies have some evidence to underpin the use of these non-pharmaceutical therapies and that a significant research gap is exists. What are the implications for practitioners? The implications for practitioners is that significant research effort is required to determine the efficacy of many of the therapies that are currently deployed, and thus many of the therapies used lack an evidence base at this time.

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