scholarly journals P11 A systematic review of the reporting of robotic cholecystectomy

BJS Open ◽  
2021 ◽  
Vol 5 (Supplement_1) ◽  
Author(s):  
G Higginbotham ◽  
F Hollowood ◽  
P Lok ◽  
B Turner ◽  
E Gull ◽  
...  
Keyword(s):  
Gallbladder Disease ◽  
Quality Data ◽  
Robotic Cholecystectomy ◽  
Conflicting Evidence ◽  
Depth Analysis ◽  
Long Term Follow Up ◽  
Study Characteristics ◽  
Meta Analyses ◽  
The Ideal

Abstract Introduction Robotic cholecystectomy (RC) is reported to be an innovative alternative to laparoscopic cholecystectomy for the surgical management of gallbladder disease. Perceived technical benefits of RC include enhanced ergonomic capabilities and visualisation. Whilst RC is becoming increasingly widespread, there is a paucity of high-quality data supporting its use, and conflicting evidence of outcomes in current literature. With accumulating reports citing complications associated with novel invasive procedures, experts have suggested that robust clinical evaluation is required. It is vital that techniques such as RC are evaluated consistently, in order for surgeons to fully educate patients about the treatment and obtain informed consent. This study aims to summarise and appraise the reporting of studies of RC. Methods Systematic searches identified all published studies reporting RC. Data collection was based on the IDEAL (Idea, Development, Exploration, Assessment, Long-term follow-up) framework. This will be used to identify key areas of reporting including; general study characteristics, patient selection, regulatory and governance arrangements, operator and centre expertise, technique description, and outcome reporting. Because the study will not aim to draw conclusions about the effectiveness of robotic surgery, meta-analyses will not be not performed. Results Systematic searches identified 1425 abstracts; 90 full-text papers were included. Results will be summarised in a narrative synthesis and further data will be analysed prior to presentation. Conclusion This in-depth analysis of the published literature on RC will provide evidence to understand how this innovative procedure has been introduced and evaluated in relation to the IDEAL recommendations.

The Ideal LT-Recipient - Single Center Experience From Two Decades Long Term Follow-Up.

2014 ◽  
Vol 98 ◽  
pp. 730
Author(s):  
W. Schoening ◽  
N. Buescher ◽  
R. Neuhaus ◽  
A. Pascher ◽  
G. Puhl ◽  
...  
Keyword(s):  
Single Center ◽  
Single Center Experience ◽  
Long Term Follow Up ◽  
The Ideal

The Switch Back Ross Operation: Report of Two Cases With Good Medium-to-Long-Term Follow-Up

2012 ◽  
Vol 3 (2) ◽  
pp. 244-248 ◽  
Author(s):  
Walter Vicente ◽  
Cesar Augusto Ferreira ◽  
Jyrson Guilherme Klamt ◽  
Paulo Henrique Manso ◽  
Oswaldo Cesar Almeida Filho ◽  
...  
Keyword(s):  
Arterial Switch Operation ◽  
Valve Surgery ◽  
Valve Regurgitation ◽  
Ross Operation ◽  
Switch Operation ◽  
Long Term Follow Up ◽  
Good Medium ◽  
The Ideal

Submitted July 20, 2011; Accepted October 6, 2011. Neoaortic root dilatation and neoaortic valve regurgitation following the arterial switch operation for transposition of the great arteries may ultimately require neoaortic root and/or neoaortic valve surgery. The ideal surgical approach to these lesions remains debatable. Hazekamp et al, in 1997, introduced the replacement of the neoaortic root by the neopulmonary autograft and named this procedure the switch back Ross operation. We report two patients who were successfully treated at our institution with the switch back Ross operation, with good results at, respectively, four- and five-year follow-up.

scholarly journals Stapled Haemorrhoidopexy Compared with Conventional Haemorrhoidectomy-A Systematic Review

2012 ◽  
Vol 7 (1) ◽  
pp. 37-41 ◽  
Author(s):  
ASMT Rahman ◽  
ASMZ Rahman ◽  
SK Biswas ◽  
KR Majumder ◽  
G Biswas
Keyword(s):  
Surgical Management ◽  
Current Evidence ◽  
Stapled Haemorrhoidopexy ◽  
Randomized Controlled ◽  
Long Term Follow Up ◽  
Conventional Haemorrhoidectomy ◽  
Meta Analyses ◽  
Excisional Surgery

Haemorrhoids are one of the most common anorectal disorders. Conventional haemorrhoidectomy (CH) is the most commonly practiced surgical technique. Stapled haemorrhoidopexy (SH) [procedure for prolapsed haemorrhoids (PPH)] is newly developed method for the surgical management of Haemorrhoids. This review looks at the surgical management of prolapsed haemorrhoids in light of this recent development and suggests a treatment approach based on this current evidence. A Medline, Pubmed and Cochrane data base search was performed using key words "haemorrhoid" or 'hemorrhoid' and staple. Relevant papers e.g. randomized controlled trials, review and metaanalyses from different parts of the world were collected. Data were analyzed and compiled. Though early small RCTs (stapled haemorrhoidopexy comparing with traditional excisional surgery) have shown stapled haemorrhoidopexy is less painful and it is associated with quicker recovery but recent large meta-analyses and long term follow up have shown SH is associated with a higher long term risk of haemorrhoid recurrence and symptoms of prolapse.DOI: http://dx.doi.org/10.3329/fmcj.v7i1.10297Faridpur Med. Coll. J. 2012;7(1): 37-41

scholarly journals Identifying research waste from surgical research: a protocol for assessing compliance with the IDEAL framework and recommendations

2021 ◽  
Vol 3 (1) ◽  
pp. e000050
Author(s):  
Jiajie Yu ◽  
Fei Shan ◽  
Allison Hirst ◽  
Peter McCulloch ◽  
Youping Li ◽  
...  
Keyword(s):  
Biomedical Research ◽  
General Information ◽  
Research Waste ◽  
Research Investment ◽  
Long Term Follow Up ◽  
Key Aspects ◽  
Ideal Framework ◽  
Future Education ◽  
The Ideal

IntroductionApproximately £1130 billion was invested in research worldwide in 2016, and 9.6% of this was on biomedical research. However, about 85% of biomedical research investment is wasted. The Lancet published a series to identify five categories relating to research waste and in 2014. Some categories of research waste in surgery are avoidable by complying with the Idea, Development, Exploration, Assessment, Long-term follow-up (IDEAL) framework for it enables researchers to design, conduct and report surgical studies robustly and transparently. This review aims to examine the extent to which surgical studies adhered to the IDEAL framework and estimate the amount of overall research waste that could be avoided if compliance was improved.MethodsWe will search for potential studies published in English and between 1 January 2018 and 31 December 2018 via PubMed. Teams of paired reviewers will screen titles, abstracts and full texts independently. Two researchers will extract data from each paper. Data will be collected about general information and specialised information in each stage, and our IDEAL Compliance Appraisal tool will be used to analyse included studies. Descriptive statistics and χ2 or Fisher’s exact tests for comparisons will be presented.DiscussionOur study will provide important information about whether compliance with the specific IDEAL Recommendations has reduced research waste in surgical and therapeutic device studies. And we will identify particular key aspects that are worse and need to focus on improving those in future education.

Corneal Collagen Crosslinking for Corneal Ectasias: A Review

2016 ◽  
Vol 27 (3) ◽  
pp. 253-269 ◽  
Author(s):  
David P.S. O’Brart
Keyword(s):  
Case Series ◽  
Collagen Crosslinking ◽  
Randomized Controlled Clinical Trials ◽  
Long Term Follow Up ◽  
Corneal Collagen Crosslinking ◽  
Meta Analyses ◽  
Term Data ◽  
Corneal Collagen

Purpose To review the published literature on corneal collagen crosslinking (CXL). Methods Importance has been placed on seminal publications, systemic reviews, meta-analyses, and randomized controlled clinical trials. Where such evidence was not available, cohort studies, case-controlled studies, and case series with follow-up greater than 12 months were examined. Results Corneal collagen crosslinking with riboflavin and ultraviolet A (UVA) 370 nm radiation appears to be capable of arresting the progression of ectatic corneal disorders, with most studies reporting significant improvements in visual, keratometric, and topographic measurements. Its mode of action at the molecular level is undetermined. Follow-up is limited to 5-10 years but suggests sustained stability and enhancement in corneal shape with time. Nearly all published long-term data and comparative studies are with epithelium-off techniques. Epithelium-on investigations suggest some efficacy but less than with epithelium-off treatments and long-term data are unavailable. Accelerated techniques with higher UVA fluencies and shorter treatments times, delivering the same UVA energy dosage, are the subject of recent investigation, with some laboratory and clinical studies suggesting reduced efficacy compared to the standard 3 mW/cm2 for 30 minutes irradiation procedure. Combined methodologies of CXL with techniques such as photorefractive keratectomy and intrastromal rings show promise but long-term follow-up is indicated. Sight-threatening complications of CXL are rare. Conclusions Studies of epithelium-off CXL with irradiation at 3 mW/cm2 for 30 minutes support its efficacy. Refinement in techniques may allow for safer and more rapid procedures with less patient discomfort but require further investigation.

scholarly journals 1045 Summarising the Reporting of Regulatory Procedures in Robotic Cholecystectomy: A Systematic Review and Narrative Synthesis

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
G Higginbotham ◽  
E Gull ◽  
D Henshall ◽  
I Handa ◽  
O Brewster ◽  
...  
Keyword(s):  
New Technologies ◽  
Conflicts Of Interest ◽  
Surgical Techniques ◽  
Evidence Base ◽  
Robotic Cholecystectomy ◽  
Patient Consent ◽  
Ethical Approval ◽  
Long Term Follow Up ◽  
Study Characteristics ◽  
Randomised Controlled

Abstract Introduction Robotic cholecystectomy (RC) represents the most recent innovation in the management of gallstones. Whilst RC is becoming increasingly widespread, the evidence base surrounding its introduction has not been characterised. When evaluating innovative surgical techniques, adherence to regulatory and governance procedures is essential in maintaining patient safety. This study aims to appraise the reporting of studies of RC, focussing on regulatory procedures. Method Systematic searches identified all published studies reporting RC. Data collection was based on the IDEAL (Idea, Development, Exploration, Assessment, Long-term follow-up) framework, and included general study characteristics, governance approvals, trial registration, study funding, conflicts of interests, and information communicated to patients. Results Systematic searches identified 1425 abstracts. Of the 90 full-text papers included, only three were randomised controlled trials. The majority (71%) were single-centre studies. Conflicts of interest were common, with 11 (12%) studies funded by the robot manufacturer, and 23 (26%) reporting conflicts related to authors. Ethical approval was confirmed in 51 (57%) studies; four reported prior registration with a register. Only forty-two studies (47%) documented obtaining patient consent for study participation. Only four documented discussions regarding the innovative nature of RC. In ten, modifications to the robot or technique were described, but it was not apparent if patients were informed of these. Conclusions This comprehensive review highlights multiple deficiencies in the reporting of regulatory procedures in the evaluation of RC. Improved reporting is required in studies of RC to ensure transparency, interpretability, and the safe, evidence-based adoption of new technologies into clinical practice.

scholarly journals Submassive Pulmonary Embolism: Current Perspectives and Future Directions

2021 ◽  
Vol 10 (15) ◽  
pp. 3383
Author(s):  
Phillip C. Nguyen ◽  
Hannah Stevens ◽  
Karlheinz Peter ◽  
James D. McFadyen
Keyword(s):  
Pulmonary Embolism ◽  
High Risk ◽  
Thrombolytic Therapy ◽  
Current Evidence ◽  
Conflicting Evidence ◽  
Submassive Pulmonary Embolism ◽  
High Risk Disease ◽  
Systemic Thrombolytic Therapy ◽  
Meta Analyses

Submassive pulmonary embolism (PE) lies on a spectrum of disease severity between standard and high-risk disease. By definition, patients with submassive PE have a worse outcome than the majority of those with standard-risk PE, who are hemodynamically stable and lack imaging or laboratory features of cardiac dysfunction. Systemic thrombolytic therapy has been proven to reduce mortality in patients with high-risk disease; however, its use in submassive PE has not demonstrated a clear benefit, with haemodynamic improvements being offset by excess bleeding. Furthermore, meta-analyses have been confusing, with conflicting results on overall survival and net gain. As such, significant interest remains in optimising thrombolysis, with recent efforts in catheter-based delivery as well as upcoming studies on reduced systemic dosing. Recently, long-term cardiorespiratory limitations following submassive PE have been described, termed post-PE syndrome. Studies on the ability of thrombolytic therapy to prevent this condition also present conflicting evidence. In this review, we aim to clarify the current evidence with respect to submassive PE management, and also to highlight shortcomings in current definitions and prognostic factors. Additionally, we discuss novel therapies currently in preclinical and early clinical trials that may improve outcomes in patients with submassive PE.

scholarly journals Prognostic Factors for Recovery in Chronic Nonspecific Low Back Pain: A Systematic Review

2012 ◽  
Vol 92 (9) ◽  
pp. 1093-1108 ◽  
Author(s):  
Karin Verkerk ◽  
Pim A.J. Luijsterburg ◽  
Harard S. Miedema ◽  
Annelies Pool-Goudzwaard ◽  
Bart W. Koes
Keyword(s):  
Prognostic Factors ◽  
Return To Work ◽  
Pain Intensity ◽  
Short Term ◽  
Conflicting Evidence ◽  
Long Term Follow Up ◽  
Physical Job Demands

Background Few data are available on predictors for a favorable outcome in patients with chronic nonspecific low back pain (CNLBP). Purpose The aim of this study was to assess prognostic factors for pain intensity, disability, return to work, quality of life, and global perceived effect in patients with CNLBP at short-term (≤6 months) and long-term (>6 months) follow-up. Data Sources Relevant studies evaluating the prognosis of CNLBP were searched in PubMed, CINAHL, and EMBASE (through March 2010). Study Selection Articles with all types of study designs were included. Inclusion criteria were: participants were patients with CNLBP (≥12 weeks' duration), participants were older than 18 years of age, and the study was related to prognostic factors for recovery. Fourteen studies met the inclusion criteria. Data Extraction Two reviewers extracted the data and details of each study. Data Synthesis A qualitative analysis using “level of evidence” was performed for all included studies. Data were summarized in tables and critically appraised. Limitations The results of the studies reviewed were limited by their methodological weaknesses. Conclusions At short-term follow-up, no association was found for the factors of age and sex with the outcomes of pain intensity and disability. At long-term follow-up, smoking had the same result. At long-term follow-up, pain intensity and fear of movement had no association with disability. At short-term follow-up, conflicting evidence was found for the association between the outcomes pain intensity and disability and the factor of fear of movement. At long-term follow-up, conflicting evidence was found for the factors of age, sex, and physical job demands. At long-term follow-up, conflicting evidence also was found for the association between return to work and age, sex, and activities of daily living. At baseline, there was limited evidence of a positive influence of lower pain intensity and physical job demands on return to work. No high-quality studies were found for the outcomes of quality of life and global perceived effect.

Short- and long-term effects of pulmonary rehabilitation for idiopathic pulmonary fibrosis: a systematic review and meta-analysis

2018 ◽  
Vol 32 (10) ◽  
pp. 1299-1307 ◽  
Author(s):  
Li Cheng ◽  
Botao Tan ◽  
Ying Yin ◽  
Sanrong Wang ◽  
Lang Jia ◽  
...  
Keyword(s):  
Pulmonary Rehabilitation ◽  
Long Term Effects ◽  
Related Quality ◽  
Long Term Follow Up ◽  
Health Related ◽  
Short And Long Term ◽  
Meta Analyses

Objective: To investigate the short- and long-term effects of pulmonary rehabilitation in patients with idiopathic pulmonary fibrosis (IPF). Data sources: An electronic search of MEDLINE, Embase and Cochrane Central databases along with hand search of relevant papers were performed on 15 March 2018. Review methods: This study was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We searched the literature for randomized controlled trials of pulmonary rehabilitation in IPF patients. The outcomes were exercise capacity and health-related quality of life. Two authors independently extracted data, assessed trial eligibility and risk of bias. Meta-analyses were performed using RevMan and STATA software. Results: We extracted data from four randomized controlled trials (142 participants). At short-term follow-up, pulmonary rehabilitation significantly enhanced 6-minute walk distance (6-MWD; weighted mean difference (WMD) = 38.38, 95% confidence interval (CI) = 4.64–72.12, I2 = 60.7%; P < 0.05), reduced St. George’s Respiratory Questionnaire (SGRQ)/IPF-specific SGRQ (SGRQ-I) total score (WMD = –8.40, 95% CI = –11.44 to −5.36, I2 = 0%; P < 0.00001). At long-term follow-up, pulmonary rehabilitation could not enhance 6-MWD (WMD = 17.02, 95% CI = –26.87 to 60.81, I2 = 36.3%; P = 0.43) or reduce SGRQ/SGRQ-I total score (WMD = –3.45, 95% CI = –8.55 to 1.64, I2 = 38.3%; P = 0.088). Conclusion: In patients with IPF, pulmonary rehabilitation showed short-term effects in enhancing exercise capacity and health-related quality of life, while it had no detectable effects at long-term follow-up.

Targeting frail older adults for outpatient comprehensive geriatric assessment and management services: An overview of concepts and criteria

2002 ◽  
Vol 12 (1) ◽  
pp. 82-92 ◽  
Author(s):  
Faranak Aminzadeh ◽  
William B Dalziel ◽  
Frank J Molnar
Keyword(s):  
Clinical Trials ◽  
Geriatric Assessment ◽  
Comprehensive Geriatric Assessment ◽  
Older Persons ◽  
Diagnostic Process ◽  
Functional Capabilities ◽  
Long Term Follow Up ◽  
Meta Analyses

Comprehensive geriatric assessment (CGA) has been defined as ‘a multidimensional, often interdisciplinary, diagnostic process intended to determine a frail elderly person’s medical, psychosocial, and functional capabilities and problems, with the objective of developing an overall plan for treatment and long-term follow-up’. Evidence from recent meta-analyses of clinical trials of the effectiveness of CGA programmes suggest that older persons may experience a variety of health benefits from these comprehensive services.

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