scholarly journals Prestenting Versus Nonprestenting on the Outcomes of Flexible Ureteroscopy for Large Upper Urinary Stones: A Systematic Review and Meta-Analysis

2021 ◽  
pp. 1-8
Author(s):  
Xueliang Chang ◽  
Yaxuan Wang ◽  
Jingdong Li ◽  
Zhenwei Han
Keyword(s):  
Success Rate ◽  
Operative Time ◽  
Weighted Mean Difference ◽  
Meta Analysis ◽  
Urinary Stones ◽  
Flexible Ureteroscopy ◽  
Ureteral Access Sheath ◽  
Male Patients ◽  
Review Manager ◽  
Initial Success Rate

<b><i>Introduction:</i></b> The purpose of this article is to evaluate the efficacy and safety of prestenting (PS) versus non-PS (NPS) of flexible ureteroscopy (fURS) to treat large upper urinary stones. <b><i>Methods:</i></b> We conducted a systematic literature research of PubMed, Ovid, Scopus (up to August 2019), and citation lists to identify eligible studies. All studies comparing PS versus NPS of fURS were included. Data were analyzed using the Cochrane Collaboration’s Review Manager (RevMan) 5.3 software. <b><i>Results:</i></b> Overall, 7 studies including 3,145 patients (PS 1,408; NPS 1,737) were included in this article. PS group was associated with older age (weighted mean difference [WMD] 0.91 year; <i>p</i> &#x3c; 0.001) and more male patients (odds ratio [OR] 1.34; <i>p</i> &#x3c; 0.001). There were no statistical differences between PS and NPS in BMI (WMD 0.34 kg/m<sup>2</sup>; <i>p</i> = 0.13), stone size (WMD 0.13 mm; <i>p</i> = 0.77), and operative time (WMD 0.44 min; <i>p</i> = 0.86). Compared with NPS, PS showed better initial success rate (OR 4.04; <i>p</i> &#x3c; 0.001) and higher SFR (OR 1.64; <i>p</i> &#x3c; 0.001). There were no statistical differences for complications (OR 0.84; <i>p</i> = 0.42) and Clavien-Dindo score ≥3 complications (OR 1.04; <i>p</i> = 0.93). <b><i>Conclusion:</i></b> PS could improve initial success rate and avoid secondary general anesthesia for first ureteral access sheath failed patients. PS could provide better SFR than NPS in the treatment of large upper urinary stones with fURS.

scholarly journals Staple line oversewing during laparoscopic sleeve gastrectomy

2017 ◽  
Vol 99 (7) ◽  
pp. 509-514 ◽  
Author(s):  
H Wang ◽  
J Lu ◽  
J Feng ◽  
Z Wang
Keyword(s):  
Sleeve Gastrectomy ◽  
Laparoscopic Sleeve Gastrectomy ◽  
Operative Time ◽  
Web Of Science ◽  
Staple Line ◽  
Weighted Mean Difference ◽  
Meta Analysis ◽  
Significant Difference ◽  
Comprehensive Search ◽  
Randomised Controlled

Introduction This meta-analysis was performed to assess the possible benefits of staple line oversewing during laparoscopic sleeve gastrectomy. Methods A comprehensive search up to February 2017 was conducted on PubMed, the Web of Science™ and Embase™. All eligible studies were included, and the outcomes of staple line bleeding and leak, overall complications and operative time were pooled. Results A total of 7 randomised controlled trials involving 845 patients (428 cases and 417 controls) were analysed. There was no significant difference in staple line bleeding (relative risk [RR]: 0.858, 95% confidence interval [CI]: 0.343–2.143, p=0.742), leak (RR: 0.650, 95% CI: 0.257–1.644, p=0.363) or overall complications (RR: 0.913, 95% CI: 0.621–1.342, p=0.644) between the oversewing group and the patients who did not have oversewing. Oversewing of the staple line was associated with a longer operative time (weighted mean difference: 14.400, 95% CI: 7.198–21.602, p=0.000). Conclusions Oversewing the staple line during laparoscopic sleeve gastrectomy does not decrease the risk of staple line bleeding, leakage or overall complications but it does prolong the operative time.

scholarly journals Comparison of the Efficacy of ShuoTong Ureteroscopy and Simple Flexible Ureteroscopy in the Treatment of Unilateral Upper Ureteral Calculi

2021 ◽  
Vol 8 ◽  
Author(s):  
Longhui Lai ◽  
Wenzhao Zhang ◽  
Fangjian Zheng ◽  
Tao Wang ◽  
Peide Bai ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Operative Time ◽  
Ureteral Calculi ◽  
Flexible Ureteroscopy ◽  
Ureteral Stones ◽  
Ureteral Access Sheath ◽  
Hospitalization Cost ◽  
Access Sheath ◽  
Stone Free Rate ◽  
Free Rate

Background: ShuoTong ureteroscopy (Sotn-ureteroscopy, ST-URS), a new lithotripsy operation method developed on the basis of ureteroscopy, is widely used to treat ureteral stones in China. Its composition includes rigid ureteral access sheath, standard mirror, lithotripsy mirror, and ShuoTong perfusion aspirator (ST-APM). Here, we compared the efficacy and safety of the ST-URS and the flexible ureteroscope (F-URS) holmium laser lithotripsy in the treatment of unilateral upper ureteral calculi.Methods: Retrospective analysis was conducted on the clinical data of 280 patients who met the inclusion 1) urinary tract CT was diagnosed with unilateral single upper ureteral calculi above the L4 lumbar spine; 2) patient age was from 18 to 80 years old; 3) patients were informed and consented to this study; and 4) patients were approved by the hospital ethics committee (proof number: KY-2019-020) and the exclusion criteria for unilateral upper ureteral calculi in the First Affiliated Hospital of Xiamen University from January 2018 to November 2020, and they were divided into the ST-URS group and the flexible ureteroscopy (F-URS) group.Results: The stone-free rate of 1 day after operation of the ST-URS group was significantly higher than the F-URS group (63.71 vs. 34.62%, P &lt; 0.0001). The operative time (38.45 vs. 46.18 min, P = 0.005) and hospitalization cost (27,203 vs. 33,220 Yuan, P &lt; 0.0001) of the ST-URS group were significantly lower than the F-URS group. There were no significant differences in the success rate of ureteral access sheath placement, operative blood loss, stone-free rate of 1 month after operation, postoperative complications, postoperative hospital stay, and postoperative visual analog scale (VAS) pain score between the two groups (P &gt; 0.05). In subgroups of a diameter of calculi ≥ 1.5 cm, calculi CT numerical value ≥ 1,000 Hounsfield unit and the preoperative hydronephrosis range ≥ 3.0 cm, ST-URS shows more advantages in the operative time, stone-free rate of 1 day after the operation, the hospitalization cost, and the incidence of postoperative complications.Conclusion: In unilateral upper ureteral stones treated with a holmium laser, compared with the simple F-URS, the ST-URS has a shorter operative time, lower hospitalization cost, and a higher stone-free rate of 1 day after the operation, suggesting that the ST-URS could be more widely applied in clinics.

scholarly journals COMPARISON THE SUCCESS RATE OF VESICOVAGINAL FISTULA REPAIR SURGICAL WITH TRANSVAGINAL AND TRANSABDOMINAL PROCEDURE : META ANALYSIS

2020 ◽  
Vol 4 (2) ◽  
pp. 109-115
Author(s):  
Norma Pattinama ◽  
Gatut Hardianto
Keyword(s):  
Success Rate ◽  
Vesicovaginal Fistula ◽  
Meta Analysis ◽  
Google Scholar ◽  
Forest Plot ◽  
Online Database ◽  
Inclusion Criteria ◽  
Fistula Repair ◽  
Review Manager

Objective: This paper aims to evaluate the success rate of vesicovaginal fistula (VVF) repair surgery by transvaginal (TVAG) and transabdominal (TPA) procedure. Method: Literatures were searched on the online database, PUBMED and Google Scholar. All of the studies should be belonging on to inclusion criteria. The literatures had qualitative analyze by the authors and bias criteria based on Review Manager 5.3 application. It also had quantitative analyzed by the same application. Results: The literatures have 191 patients (transvaginal-n=107; transabdominal-n=84). The data was homogen (Chi2<df; P>0,05). The forest plot showed that TPA has a higher success rate than TVAG, still not statistically significant (test overall effect P>0,05; 95%CI was 0,59 to 5,30). Conclusion: Transabdominal procedure has a higher success rate.

scholarly journals Association of age, sex, comorbidities, and clinical symptoms with the severity and mortality of COVID-19 cases: a meta-analysis with 85 studies and 67299 cases

2020 ◽  
Author(s):  
Mohammad Safiqul Islam ◽  
Md. Abdul Barek ◽  
Md. Abdul Aziz ◽  
Tutun Das Aka ◽  
Md. Jakaria
Keyword(s):  
Risk Factors ◽  
Clinical Characteristics ◽  
Clinical Symptoms ◽  
Meta Analysis ◽  
Chest Tightness ◽  
Risk Of Death ◽  
Sputum Production ◽  
Male Patients ◽  
Global Threat ◽  
Review Manager

AbstractBackgroundA new pathogenic disease named COVID-19 became a global threat, first reported in Wuhan, China, in December 2019. The number of affected cases growing exponentially and now, more than 210 countries confirmed the cases.ObjectiveThis meta-analysis aims to evaluate risk factors, the prevalence of comorbidity, and clinical characteristics in COVID-19 death patients compared to survival patients that can be used as a reference for further research and clinical decisions.MethodsPubMed, Science Direct, SAGE were searched to collect data about demographic, clinical characteristics, and comorbidities of confirmed COVID-19 patients from January 1, 2020, to May 17, 2020. Meta-analysis was performed with the use of Review Manager 5.3ResultsEighty-five studies were included in Meta-analysis, including a total number of 67,299 patients with SARS-CoV-2 infection. Males are severely affected or died than females (OR = 2.26, p < 0.00001; OR = 3.59, p < 0.00001) are severely affected, or died by COVID-19 and cases with age ≥50 are at higher risk of death than age <50 years (OR=334.23). Presence of any comorbidity or comorbidities like hypertension, cardiovascular disease, diabetes, cerebrovascular disease, respiratory disease, kidney disease, liver disease, malignancy significantly increased the risk of death compared to survival (OR = 3.46, 3.16, 4.67, 2.45, 5.84, 2.68, 5.62, 2.81,2.16). Among the clinical characteristics such as fever, cough, myalgia, diarrhea, abdominal pain, dyspnea, fatigue, sputum production, chest tightness headache and nausea or vomiting, only fatigue (OR = 1.31, 95%) and dyspnea increased the death significantly (OR= 1.31, 4.57). The rate of death of COVID-19 cases is 0.03-times lower than the rate of survival (OR = 0.03).ConclusionOur result indicates that male patients are affected severely or died, the rate of death is more in the age ≥50 group, and the rate of death is affected by comorbidities and clinical symptoms.

The Outcomes of Pre-Stenting on Renal and Ureteral Stones: A Meta-Analysis

2021 ◽  
pp. 1-9
Author(s):  
Han Chen ◽  
Yang Pan ◽  
Min Xiao ◽  
Jingruo Yang ◽  
Yong Wei
Keyword(s):  
Operative Time ◽  
Meta Analysis ◽  
Renal Stones ◽  
Flexible Ureteroscopy ◽  
Ureteral Stones ◽  
Ureteroscopic Lithotripsy ◽  
Stone Free Rate ◽  
Significant Difference ◽  
Meta Analyses ◽  
Free Rate

<b><i>Background:</i></b> Pre-stenting (PS) on the outcomes of semirigid and flexible ureteroscopic lithotripsy for a different upper urinary urolithiasis remains controversial. We performed a meta-analysis comparing the outcomes of ureteroscopic lithotripsy between PS and non-PS. <b><i>Materials and Methods:</i></b> Randomized, controlled trials and observational studies comparing PS and non-PS were identified from electronic databases. Stone-free rate (SFR), operative time, and complications were compared by qualitative and quantitative syntheses (meta-analyses). <b><i>Results:</i></b> Eleven articles were included in this study. Nearly, all of recently published studies exhibited relatively moderate or high quality during quality assessment. PS was more likely to achieve good SFR compared with non-PS (<i>p</i> &#x3c; 0.00001). The subgroup results indicated that PS improved the SFR for renal stones and the stones dealt by flexible ureteroscopy (<i>p</i> = 0.0002; <i>p</i> &#x3c; 0.0001, respectively; some ureteral stones were dealt by flexible ureteroscopy). Ureteral stones and the stones dealt by semirigid ureteroscopy were not influenced by PS (<i>p</i> = 0.62; <i>p</i> = 0.90, respectively). PS is equal as non-PS in terms of operative time for renal stones and the renal and ureteral stones dealt by flexible ureteroscopy (<i>p</i> = 0.47; <i>p</i> = 0.05). No significant difference was found in major complications between the 2 groups for total or for the subgroup of renal stones (<i>p</i> = 0.3; <i>p</i> = 0.69). <b><i>Conclusions:</i></b> For ureteral stones or the stones dealt by semirigid ureteroscopy, PS does not show any benefits. For renal stones or the stones dealt by flexible ureteroscopy, PS improves the SFR and may be as safe as non-PS.

scholarly journals The difference between preserving and non-preserving left colonic artery for low rectal cancer: a meta-analysis

2020 ◽  
Vol 8 (1) ◽  
pp. 427
Author(s):  
Zakari Shaibu ◽  
Zhihong Chen
Keyword(s):  
Rectal Cancer ◽  
Blood Loss ◽  
Operative Time ◽  
Weighted Mean Difference ◽  
Meta Analysis ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Outcome Study ◽  
Weighted Mean ◽  
The Difference

Abstract Object: The aim of this study is to compare the superiority and safety of preserving and non-preserving left colonic artery. Method: PubMed, Google scholar and Medline were searched for eligible studies between 1965 to 2018. Operative time, blood loss, number of resected lymph nodes, anastomotic leakage, and ileus, and morbidity, hospital length of stay, wound infection and mortality were the main outcome study. Result: 23 studies involving 10,644 patients were included in the analyses. Compared with the preserving approach, the non-preserving approach had less operative time (weighted mean difference [WMD]=9.37 min, 95% CI [8.92,9.81], p

scholarly journals Direct anterior versus posterolateral approaches for clinical outcomes after total hip arthroplasty: a systematic review and meta-analysis

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Wang Chen ◽  
Jian-Ning Sun ◽  
Ye Zhang ◽  
Yu Zhang ◽  
Xiang-Yang Chen ◽  
...  
Keyword(s):  
Systematic Review ◽  
Blood Loss ◽  
Operative Time ◽  
Weighted Mean Difference ◽  
Meta Analysis ◽  
Length Of Hospital Stay ◽  
Operation Time ◽  
Direct Anterior Approach ◽  
Harris Hip Score ◽  
Cochrane Library

Abstract Objective The main objective of our study was to compare the intraoperative and postoperative outcomes of direct anterior approach (DAA) with posterolateral approaches (PLA). Methods We searched Cochrane library, Web of Science, and PubMed for literatures comparing DAA with PLA. On the basis of inclusion and exclusion criteria, relevant literatures were selected. Two members independently screened qualified literatures, evaluated the literature quality, and extracted data information. Results Eighteen randomized controlled trials (RCTs) and non-RCTs totaling 34,873 patients (DAA = 9636, PLA = 25237) were contained in this systematic review and meta-analysis. The results showed that DAA were reduced in terms of length of hospital stay (weighted mean difference (WMD) = −0.43, 95% confidence interval (CI) −0.78 to −0.09, P = 0.01), LLD (WMD = −2.00, 95% CI −2.75 to −1.25, P < 0.00001), PE/DVT (WMD = 0.36, 95% CI 0.15 to 0.85, P = 0.02), dislocation (WMD = 0.42, 95% CI 0.30 to 0.59, P < 0.00001) and visual analog scale (VAS) (WMD = −0.57, 95% CI −0.91 to −0.23, P = 0.0009) compared with PLA; however, DAA compared with the PLA was increasing in terms of operative time (WMD = 14.81, 95% CI 7.18 to 22.44, P = 0.0001), intraoperative blood loss (WMD = 105.13, 95% CI 25.35 to 184.90, P = 0.01), fracture (WMD = 1.46, 95% CI 1.00 to 2.11, P = 0.05), and Harris hip score (HHS) (WMD = 1.19, 95% CI 0.77 to 1.61, P < 0.00001). Conclusions DAA was preferable effectiveness to PLA in early pain relief and functional recovery; however, PLA has a shorter operation time, intraoperative less blood loss and fracture. Trial registration Registration ID, CRD42020151208

scholarly journals Rigid and flexible ureteroscopy (URS/RIRS) management of paediatric urolithiasis in a not endemic country

2021 ◽  
Vol 93 (1) ◽  
pp. 26-30
Author(s):  
Stefania Ferretti ◽  
Monica Cuschera ◽  
Davide Campobasso ◽  
Claudia Gatti ◽  
Riccardo Milandri ◽  
...  
Keyword(s):  
Success Rate ◽  
Urinary Stone ◽  
Urinary Stones ◽  
Flexible Ureteroscopy ◽  
Residual Stone ◽  
Reliable Technique ◽  
Endoscopic Procedures ◽  
Stone Free Rate ◽  
Free Rate ◽  
Free Status

Introduction: In the last years due to miniaturization of endoscopic instruments and percutaneous surgery, endourology has become very popular in paediatric urinary stone managment. We reported our single-centre experience in retrograde endoscopic procedures in children. Results and complications of URS/RIRS are discussed. Materials and methods: We retrospectively reviewed our experience in patients ≤ 16 years old affected by urinary stones who underwent URS/RIRS procedures performed by two surgeons with expertise in endourology. A total of 30 renal Units (RUs) underwent endoscopic procedures (URS, RIRS or both). Surgical complications according to the ClavienDindo’s classification and stone-free rate were evaluated at 3 months follow-up. Success of URS was defined as stone-free status after single procedure while RIRS success rate was considered as presence of residual stone fragments smaller than 4 mm at first procedure. Results: The mean age of our patients was 8 years, range 2- 16 years. A total of 30 renal units (RUs) underwent 40 endourological procedures (23 URS and 17 RIRS; 10 children underwent both procedures at the same time). 17/30 (56.6%) RUs were pre-stented before surgery. The stone-free status was achieved in 23/30 renal units treated, with a 76.6% success rate. The remaining 7 patients had residual stones greater than 4 mm and underwent further treatments. After a second surgery the stone-free rate turned out to be 93.3% (28/30 renal units). Conclusions: Rigid and flexible ureteroscopy (URS/RIRS) is a reliable technique for treatment of < 2 cm urinary stones in paediatric age group. It shows low rate of major complications and promising results in terms of stone-free rate.

scholarly journals Effect of Desflurane versus Sevoflurane in Pediatric Anesthesia: A Meta-Analysis

2015 ◽  
Vol 18 (2) ◽  
pp. 199 ◽  
Author(s):  
Jiaxuan He ◽  
Yong Zhang ◽  
Rongliang Xue ◽  
Jianrui Lv ◽  
Xiaoying Ding ◽  
...  
Keyword(s):  
Weighted Mean Difference ◽  
Meta Analysis ◽  
Pediatric Anesthesia ◽  
Fixed Effect Model ◽  
Cochrane Library ◽  
Weighted Mean ◽  
Effect Model ◽  
Extubation Time ◽  
Eye Opening ◽  
Review Manager

Purpose: To compare the effect of desflurane versus sevoflurane in pediatric anesthesia by conducting meta-analysis. Methods: Studies were searched from PubMed, Medline, Springer, Elsevier Science Direct, Cochrane Library and Google Scholar up to July 2014. Weighted mean difference (WMD) or risk ratio (RR) and 95% confidence intervals (CIs) were considered as effect sizes. Heterogeneity across studies was assessed by Cochran Q test and I2 statistic. The random effects model was performed in the meta-analysis when heterogeneity was observed, or the fixed effect model was used. Review Manager 5.1 software was applied for the meta-analysis. Results: A total of 11 studies (13 comparisons) involving 1,273 objects were included in this meta-analysis. No heterogeneity was observed between studies for any comparison but for postoperative extubation time. The results showed significant differences between desflurane and sevoflurane groups for postoperative extubation time (WMD = -3.87, 95%CI = -6.14 to -1.60, P < 0.01), eye opening time (WMD = -1.11, 95%CI = -1.49 to -0.72, P < 0.01), awakening time (WMD = -4.27, 95%CI = -5.28 to -3.26, P < 0.01) and agitation (RR = 1.44, 95%CI = 1.05 to 1.96, P = 0.02). No significant differences (P > 0.05) were detected for discharge from the recovery room, oculocardiac reflex, nausea and vomiting and severe pain. Conclusions: Desflurane may have less adverse effects than sevoflurane when used in pediatric anesthesia with significantly shorter postoperative extubation time, eye opening time and awakening time as well as slighter agitation. This article is open to POST-PUBLICATION REVIEW. Registered readers (see “For Readers”) may comment by clicking on ABSTRACT on the issue’s contents page.

scholarly journals Punch Incision versus Elliptical Excision for Epidermal Inclusion Cysts: Systematic Review and Meta-Analysis

Surgeries ◽  
2021 ◽  
Vol 2 (3) ◽  
pp. 335-346
Author(s):  
Kengo Mukuda ◽  
Jun Watanabe
Keyword(s):  
Operative Time ◽  
Small Sample Size ◽  
Meta Analysis ◽  
Small Sample ◽  
Postoperative Wound ◽  
Randomized Controlled ◽  
Clinical Registries ◽  
The Mean ◽  
Wound Length ◽  
Review Manager

Punch incision is an alternative to elliptical excision for treating epidermal inclusion cysts, but its efficacy has not been systematically reviewed. This study assessed the efficacy and safety of punch incision versus elliptical excision for epidermal inclusion cysts. Randomized controlled trials published through January 2021 that evaluated the performance of punch incision versus elliptical excision on epidermal inclusion cysts were identified through electronic databases and clinical registries. Version 2 of the Cochrane risk-of-bias tool for randomized trials tool was used. Review Manager software was used for the meta-analysis. Two trials (100 participants) were identified. The primary outcomes were recurrence rate (risk ratio, 2.40; 95% confidence interval [CI], 0.37–15.60 [favoring elliptical excision]), mean operative time (mean difference [MD], −5.28; 95% CI, −12.72 to 2.16 [favoring punch incision]), and mean postoperative wound length (MD, −11.67; 95% CI, −20.59 to −2.76 [favoring punch incision]). The evidence was low to moderate due to the small sample size and its considerable heterogeneity. The use of punch incision shortened the mean postoperative wound length and had comparable safety to that of elliptical excision.

Sign in / Sign up

Export Citation Format

Share Document