Lack of Oncological Benefit from Bursectomy in Radical Gastrectomy: A Systematic Review

2021 ◽  
pp. 1-10
Author(s):  
Pankaj Kumar Garg ◽  
Ashish Jakhetiya ◽  
Kiran Kalyan Turaga ◽  
Rahul Kumar ◽  
Andreas Brandl ◽  
...  
Keyword(s):  
Overall Survival ◽  
Gastric Adenocarcinoma ◽  
Systematic Reviews ◽  
Disease Recurrence ◽  
Assessment Tools ◽  
Published Data ◽  
Radical Gastrectomy ◽  
Significant Difference ◽  
Omental Bursa ◽  
Meta Analyses

<b><i>Background:</i></b> Resection of the omental bursa has been suggested to reduce peritoneal recurrence and facilitate a complete oncological resection during a gastrectomy. The addition of this procedure increases technical complexity and prolongs the procedure. Published data regarding the oncological benefit of this procedure are conflicting. We hypothesized that a bursectomy during a radical gastrectomy does not improve overall survival. <b><i>Methods:</i></b> In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) reporting guideline, a comprehensive literature search of 3 electronic databases (PubMed, Scopus, and Embase) was conducted to identify the clinical studies that compared bursectomy with no-bursectomy in radical gastrectomy for gastric adenocarcinoma. Qualitative and quantitative data synthesis was performed using RevMan software. A random-/fixed-effect modeling was used depending upon the heterogeneity. Bias and quality assessment tools were applied. The study was registered with the International Prospective Register of Systematic Reviews (PROSPERO) (CRD42019116556). <b><i>Results:</i></b> Of 8 studies assessing the role of bursectomy in gastric adenocarcinoma, 6 (75%) were included – of which 2 (33%) are randomized controlled trials. Of 2,904 patients, 1,273 (%) underwent a bursectomy. There was no statistically significant difference in either overall survival (hazard ratio [HR] = 0.89, 95% CI 0.75–1.06, <i>I</i><sup>2</sup> = 14%) or disease recurrence (HR = 1.01, 95% CI 0.84–1.20, <i>I</i><sup>2</sup> = 22%) in the bursectomy group compared to the no-bursectomy group. <b><i>Conclusion:</i></b> There is no additional oncological benefit of adding bursectomy to radical gastrectomy in all patients with gastric adenocarcinoma.

scholarly journals Relationship between hospital or surgeon volume and outcomes in joint arthroplasty: protocol for a suite of systematic reviews and dose–response meta-analyses

BMJ Open ◽  
2018 ◽  
Vol 8 (12) ◽  
pp. e022797 ◽  
Author(s):  
Xiang-Dong Wu ◽  
Meng-Meng Liu ◽  
Ya-Ying Sun ◽  
Zhi-Hu Zhao ◽  
Quan Zhou ◽  
...  
Keyword(s):  
Systematic Reviews ◽  
Dose Response ◽  
Data Extraction ◽  
Meta Analysis ◽  
High Volume ◽  
Joint Arthroplasty ◽  
Surgeon Volume ◽  
Published Data ◽  
Records Management ◽  
Meta Analyses

IntroductionJoint arthroplasty is a particularly complex orthopaedic surgical procedure performed on joints, including the hip, knee, shoulder, ankle, elbow, wrist and even digit joints. Increasing evidence from volume–outcomes research supports the finding that patients undergoing joint arthroplasty in high-volume hospitals or by high-volume surgeons achieve better outcomes, and minimum case load requirements have been established in some areas. However, the relationships between hospital/surgeon volume and outcomes in patients undergoing arthroplasty are not fully understood. Furthermore, whether elective arthroplasty should be restricted to high-volume hospitals or surgeons remains in dispute, and little is known regarding where the thresholds should be set for different types of joint arthroplasties.Methods and analysesThis is a protocol for a suite of systematic reviews and dose–response meta-analyses, which will be amended and updated in conjunction with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols. Electronic databases, including PubMed and Embase, will be searched for observational studies examining the relationship between the hospital or surgeon volume and clinical outcomes in adult patients undergoing primary or revision of joint arthroplasty. We will use records management software for study selection and a predefined standardised file for data extraction and management. Quality will be assessed using the Newcastle-Ottawa Scale, and the meta-analysis, subgroup analysis and sensitivity analysis will be performed using Stata statistical software. Once the volume–outcome relationships are established, we will examine the potential non-linear relationships between hospital/surgeon volume and outcomes and detect whether thresholds or turning points exist.Ethics and disseminationEthical approval is not required, because these studies are based on aggregated published data. The results of this suite of systematic reviews and meta-analyses will be submitted to peer-reviewed journals for publication.PROSPERO registration numberCRD42017056639.

scholarly journals Efficacy of perioperative immunonutrition in visceral surgery: an umbrella review protocol

BMJ Open ◽  
2021 ◽  
Vol 11 (9) ◽  
pp. e053851
Author(s):  
Karem Slim ◽  
Flora Badon ◽  
Charles-Hervé Vacheron ◽  
Chadli Dziri ◽  
Thomas Marquillier
Keyword(s):  
Systematic Reviews ◽  
Surgical Site Infections ◽  
Visceral Surgery ◽  
Hospital Length Of Stay ◽  
Bibliographic Databases ◽  
Measurement Tool ◽  
Published Data ◽  
Umbrella Review ◽  
Meta Analyses

IntroductionImmunonutrition (IN) is generally used before major visceral surgery with the intent to reduce postoperative complications, especially infectious ones. However, the conclusions of published meta-analyses are conflicting. The purpose of this review is to synthesise the data of published systematic reviews on the effectiveness of IN.Methods and analysisThis protocol follows the Preferred Reporting Items for Systematic Reviews and Meta-analyses Protocols guidelines. This is an umbrella review of systematic reviews comparing IN (delivered orally 5–7 days preoperatively) with normal diet or isocaloric isonitrogenous feeding before visceral surgery performed on any of several viscera (colorectum, stomach, pancreas, liver, oesophagus). We search the systematic reviews included in the main bibliographic databases. To assess the efficacy of IN, several outcomes will be considered: the main outcome is infectious complications (surgical site infections, pulmonary infections or urinary infections) and secondary outcomes are overall morbidity, hospital length of stay and mortality. Identified reviews will be screened by two independent assessors. The methodological quality of relevant included reviews will be assessed using A MeaSurement Tool to Assess systematic Reviews (AMSTAR) instrument. The data extracted from included reviews will be synthesised using the r-Metafor package considering separate groups according to the viscus of interest. Publication bias will be evaluated, and subgroup analyses will be performed according to the quality of studies and preoperative nutritional status.Ethics and disseminationAn umbrella review based on published data from systematic reviews needs no ethical approval. Furthermore, no patient will be involved in the review. Once terminated, the review will be submitted for publication in an open access journal to ensure wide dissemination of the findings.PROSPERO registration numberCRD42021255177.

scholarly journals A Systematic Review of Collective Evidences Investigating the Effect of Diabetes Monitoring Systems and Their Application in Health Care

2021 ◽  
Vol 12 ◽  
Author(s):  
Maria Kamusheva ◽  
Konstantin Tachkov ◽  
Maria Dimitrova ◽  
Zornitsa Mitkova ◽  
Gema García-Sáez ◽  
...  
Keyword(s):  
Systematic Review ◽  
Systematic Reviews ◽  
Research Question ◽  
Glucose Monitoring ◽  
Monitoring Systems ◽  
Regular Control ◽  
Significant Difference ◽  
Meta Analyses ◽  
Diabetes Monitoring

IntroductionDiabetes monitoring systems (DMS) are a possible approach for regular control of glucose levels in patients with Type 1 or 2 diabetes in order to improve therapeutic outcomes or to identify and modify inappropriate patient behaviors in a timely manner. Despite the significant number of studies observing the DMS, no collective evidence is available about the effect of all devices.GoalTo review and consolidate evidences from multiple systematic reviews on the diabetes monitoring systems and the outcomes achieved.Materials and methodsInternet-based search in PubMed, EMBASE, and Cochrane was performed to identify all studies relevant to the research question. The data regarding type of intervention, type of diabetes mellitus, type of study, change in clinical parameter(s), or another relevant outcome were extracted and summarized.ResultsThirty-three out of 1,495 initially identified studies, involving more than 44,100 patients with Type 1, Type 2, or gestational diabetes for real-time or retrospective Continuous Glucose Monitoring (CGMS), Sensor Augmented Pump Therapy (SAPT), Self-monitoring Blood Glucose (SMBG), Continuous subcutaneous insulin infusion (CSII), Flash Glucose Monitoring (FGM), Closed-loop systems and telemonitoring, were included. Most of the studies observed small nominal effectiveness of DMS. In total 11 systematic reviews and 15 meta-analyses, with most focusing on patients with Type 1 diabetes (10 and 6, respectively), reported a reduction in glycated hemoglobin (HbA1c) levels from 0.17 to 0.70% after use of DMS.ConclusionCurrent systematic review of already published systematic reviews and meta-analyses suggests that no statistically significant difference exists between the values of HbA1c as a result of application of any type of DMS. The changes in HbA1c values, number and frequency of hypoglycemic episodes, and time in glucose range are the most valuable for assessing the appropriateness and effectiveness of DMS. Future more comprehensive studies assessing the effectiveness, cost-effectiveness, and comparative effectiveness of DMS are needed to stratify them for the most suitable diabetes patients’ subgroups.

Glioblastoma and bevacizumab in elderly patients: Monocentric study

2020 ◽  
pp. 107815522094039
Author(s):  
Eduardo Barrascout ◽  
Michele Lamuraglia
Keyword(s):  
Overall Survival ◽  
Elderly Patients ◽  
Clinical Benefit ◽  
Progression Free Survival ◽  
Recurrent Glioblastoma ◽  
Assessment Tools ◽  
Elderly Age ◽  
Multicentric Study ◽  
Free Survival ◽  
Significant Difference

Purpose A retrospective monocentric comparison of progression-free survival, overall survival, clinical benefit and tolerability between elderly (age>70) and non-elderly (age ≤ 70) patients receiving bevacizumab for recurrent glioblastoma. Methods We analyzed 47 patients with recurrent glioblastoma receiving bevacizumab (10 mg/kg every 14 days) between January 2011 and January 2014. Bevacizumab was introduced for all patients at recurrence after a first-line treatment by temozolomide. Results Nineteen patients were classified as elderly and 28 patients as non-elderly. No statistically significant difference was detected in the groups in terms of progression-free survival (3.8 vs. 4.1 months, p > 0.05) and overall survival at relapse (5.5 vs. 6.5 months, p > 0.05). A significant ( p = 0.01) improvement of Karnofsky Performance Status Scale was observed in non-elderly patients. Conclusions Despite the small number of patients in this retrospective study, the efficacy and safety of bevacizumab in recurrent glioblastoma appear similar in elderly and non-elderly patients. However, clinical benefit seemed to be less evident in younger patients. A prospective multicentric study integrating geriatric assessment tools and quality of life metrics would be interesting in this patient population.

scholarly journals Long-term safety of prenatal and neonatal exposure to paracetamol: a protocol for a systematic review

2020 ◽  
Vol 4 (1) ◽  
pp. e000907
Author(s):  
Samira Samiee-Zafarghandy ◽  
Katelyn Sushko ◽  
John Van Den Anker
Keyword(s):  
Systematic Review ◽  
Adverse Events ◽  
Systematic Reviews ◽  
Evidence Synthesis ◽  
Knowledge Exchange ◽  
Newborn Infants ◽  
Assessment Tools ◽  
Neonatal Exposure ◽  
Meta Analyses

IntroductionA surge in the use of paracetamol in neonates has resulted in growing concerns about its potential long-term adverse events. In this study, we conduct a systematic review of the long-term safety of prenatal and neonatal exposure to paracetamol in newborn infants.Methods and analysisWe will follow the Joanna Briggs Institute Manual for Evidence Synthesis and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statements to conduct and report this review. We will conduct a systematic search of Embase, MEDLINE, Web of Science and Google Scholar for studies with data on long-term adverse events in neonates that were exposed to paracetamol in the prenatal and/or neonatal period. We will not apply language or design limitations. We will use standardised risk of bias assessment tools to perform a quality assessment of each included article.Ethics and disseminationThis systematic review will only involve access to publicly available data, and therefore ethical approval will not be required. The results of this study will be communicated to the target audience through peer-reviewed publication as well as other knowledge exchange platforms, such as conferences, congresses or symposia.Trial registrationThe protocol for this systematic review is submitted for registration to international database of prospectively registered systematic reviews (PROSPERO, awaiting registration number).

Methodological quality and reporting of systematic reviews in hand and wrist pathology

2017 ◽  
Vol 42 (8) ◽  
pp. 852-856 ◽  
Author(s):  
J. Wasiak ◽  
A. Y. Shen ◽  
R. Ware ◽  
T. J. O’Donohoe ◽  
C. M. Faggion
Keyword(s):  
Systematic Reviews ◽  
Methodological Quality ◽  
Reporting Quality ◽  
Assessment Tools ◽  
Cochrane Library ◽  
Measurement Tool ◽  
Level Of Evidence ◽  
Methodological Assessment ◽  
Meta Analyses

The objective of this study was to assess methodological and reporting quality of systematic reviews in hand and wrist pathology. MEDLINE, EMBASE and Cochrane Library were searched from inception to November 2016 for relevant studies. Reporting quality was evaluated using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and methodological quality using a measurement tool to assess systematic reviews, the Assessment of Multiple Systematic Reviews (AMSTAR). Descriptive statistics and linear regression were used to identify features associated with improved methodological quality. A total of 91 studies were included in the analysis. Most reviews inadequately reported PRISMA items regarding study protocol, search strategy and bias and AMSTAR items regarding protocol, publication bias and funding. Systematic reviews published in a plastics journal, or which included more authors, were associated with higher AMSTAR scores. A large proportion of systematic reviews within hand and wrist pathology literature score poorly with validated methodological assessment tools, which may affect the reliability of their conclusions. Level of evidence: I

Meniscus repair failure risk does not differ by sex: a systematic review

2020 ◽  
Vol 5 (2) ◽  
pp. 98-102
Author(s):  
Christopher Hamilton ◽  
David C Flanigan ◽  
Kishan H Patel ◽  
Nathaniel Lundy ◽  
Ryan Blackwell ◽  
...  
Keyword(s):  
Systematic Review ◽  
Patient Reported Outcomes ◽  
Meniscus Repair ◽  
Published Data ◽  
Level Of Evidence ◽  
Female Patients ◽  
Failure Risk ◽  
Significant Difference ◽  
Patient Reported ◽  
Meta Analyses

ImportanceMeniscus tears are common knee pathologies that are frequently treated with meniscus repair with a variety of techniques. Regardless of technique and implant choice, it is critical to understand and consider patient factors, including patient sex, which can influence outcome.ObjectiveWe sought to determine if there is an effect of sex on failure risk following meniscus repair.Evidence reviewA systematic review of the literature was undertaken to identify studies that reported failure risk independently for male and female patients. Meta-analyses were performed to identify the effect of patient sex on meniscus repair failure risk. Differences in patient-reported outcomes by sex were reported qualitatively.FindingsA total of 886 patients analysed were included in the 11 identified studies, including 556 males and 330 females. Meniscus repair failure was reported in 192 patients (21.7%). The failure risk was 21.1% in males and 21.5% in females. Meta-analyses demonstrated no significant difference in meniscus repair failure risk based on sex in neither the three studies that assessed repair success arthroscopically (p=0.66) nor the eight studies in which failure was defined with clinical assessment or as the need for repeat surgery (p=0.92).Conclusions and relevanceThere are no significant differences in meniscus repair failure risk in male versus female patients in the existing literature. More published data are needed to evaluate patient-reported outcomes of meniscus repair based on sex.Level of evidenceIV, systematic review.

scholarly journals Efficacy and safety of levetiracetam in children with epilepsy: protocol for an umbrella review of systematic reviews and meta-analyses of randomised controlled trials

BMJ Open ◽  
2019 ◽  
Vol 9 (7) ◽  
pp. e029811 ◽  
Author(s):  
Jing Gan ◽  
Dan Ma ◽  
Tao Xiong
Keyword(s):  
Systematic Reviews ◽  
Randomised Controlled Trials ◽  
Assessment Tools ◽  
Controlled Trials ◽  
Efficacy And Safety ◽  
Umbrella Review ◽  
Randomised Controlled ◽  
Meta Analyses ◽  
Paediatric Epilepsy

IntroductionEpilepsy causes serious suffering in children and is associated with high morbidity and increased mortality. It impairs children’s quality of life and places a heavy burden on healthcare resources. Levetiracetam has been used to prevent and treat paediatric epilepsy for years. To date, a number of systematic reviews have been performed to assess the efficacy and safety of levetiracetam in a variety of clinical settings. Conflicting outcomes have been reported for the same clinical issues. Our objective is to provide a comprehensive overview of the literature for clinicians and policymakers via an umbrella review that assesses the efficacy and safety of levetiracetam in children with epilepsy.Methods and analysisWe will follow the Joanna Briggs Institute’s guidelines for umbrella reviews and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. The following seven databases will be searched from 1990 to February 2019: PubMed, Embase, Cochrane Database of Systematic Reviews, JBISRIR, EPPI, Epistemonikos and PROSPERO. We will provide evidence from existing systematic reviews and meta-analyses of randomised controlled trials regarding the use of levetiracetam in children with epilepsy. The intervention of interest is levetiracetam monotherapy and add-on therapies for prevention or treatment purposes. Studies will be individually selected and assessed by two reviewers. The primary outcomes of interest are epilepsy control, the efficacy of prophylaxis for provoked seizures and the mortality rate of children with epilepsy who received levetiracetam treatment. The secondary outcomes are adverse events and withdrawal rates due to adverse effects. The methodological quality of all reviews will be individually assessed by two reviewers using the ‘A Measurement Tool to Assess Systematic Reviews’ instrument. The Grading of Recommendations Assessment, Development and Evaluation assessment will be applied to evaluate the quality of evidence for each outcome of interest. A narrative description of an analysis of the systematic reviews will be tabulated to address objective and specific questions. Information from each review will be detailed in a table including the population, number of studies, total number of participants, year range of the trials, study designs of the primary trials, countries and settings of the trials, heterogeneity of results and assessment tools. Recommendations regarding each outcome of levetiracetam will be categorised based on a protocol.Ethics and disseminationThis umbrella review will inform clinical and policy decisions regarding the efficacy and safety of levetiracetam for preventing and treating paediatric epilepsy. The results will be disseminated through a peer-reviewed publication and conference presentations. Ethical approval is not required for this study.

scholarly journals Quality assessment tools used in systematic reviews of in vitro studies: A systematic review

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Linh Tran ◽  
Dao Ngoc Hien Tam ◽  
Abdelrahman Elshafay ◽  
Thao Dang ◽  
Kenji Hirayama ◽  
...  
Keyword(s):  
Quality Assessment ◽  
Systematic Reviews ◽  
In Vitro Studies ◽  
Assessment Tools ◽  
Increasing Trend ◽  
Meta Analyses ◽  
Critical Aspects

Abstract Background Systematic reviews (SRs) and meta-analyses (MAs) are commonly conducted to evaluate and summarize medical literature. This is especially useful in assessing in vitro studies for consistency. Our study aims to systematically review all available quality assessment (QA) tools employed on in vitro SRs/MAs. Method A search on four databases, including PubMed, Scopus, Virtual Health Library and Web of Science, was conducted from 2006 to 2020. The available SRs/MAs of in vitro studies were evaluated. DARE tool was applied to assess the risk of bias of included articles. Our protocol was developed and uploaded to ResearchGate in June 2016. Results Our findings reported an increasing trend in publication of in vitro SRs/MAs from 2007 to 2020. Among the 244 included SRs/MAs, 126 articles (51.6%) had conducted the QA procedure. Overall, 51 QA tools were identified; 26 of them (51%) were developed by the authors specifically, whereas 25 (49%) were pre-constructed tools. SRs/MAs in dentistry frequently had their own QA tool developed by the authors, while SRs/MAs in other topics applied various QA tools. Many pre-structured tools in these in vitro SRs/MAs were modified from QA tools of in vivo or clinical trials, therefore, they had various criteria. Conclusion Many different QA tools currently exist in the literature; however, none cover all critical aspects of in vitro SRs/MAs. There is a need for a comprehensive guideline to ensure the quality of SR/MA due to their precise nature.

scholarly journals Evaluating the Quality of Systematic Reviews and Meta-Analyses About Breast Augmentation Using AMSTAR

2021 ◽  
Author(s):  
Morgan Yuan ◽  
Jeremy Wu ◽  
Ryan E Austin ◽  
Frank Lista ◽  
Jamil Ahmad
Keyword(s):  
Impact Factor ◽  
Systematic Reviews ◽  
Breast Augmentation ◽  
Methodological Quality ◽  
Assessment Tools ◽  
Cochrane Library ◽  
Measurement Tool ◽  
Meta Analyses ◽  
Number Of Citations

Abstract Background Breast augmentation is one of the most commonly performed cosmetic surgeries worldwide. Therefore, it is imperative to have evidence with high methodological quality to guide clinical decision making. Objectives To evaluate the methodological quality of the systematic reviews (SRs) focused on breast augmentation. Methods: A comprehensive search of MEDLINE, Embase and the Cochrane Library of Systematic Reviews was performed. SRs that have a particular focus on breast augmentation and were published in the top 15 plastic and reconstructive surgery journals were included. Quality assessment was performed using A Measurement Tool to Assess Systematic Reviews (AMSTAR). Study characteristics were extracted including journal and impact factor, year of publication, country affiliation of corresponding author, reporting adherence to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, number of citations, and number of studies included. Results Among the 22 studies included for analysis, the mean AMSTAR score was moderate (5.55), with no SR achieving good quality (AMSTAR score ≥9). There were no significant associations between AMSTAR score and journal impact factor, number of citations, year of publication, or number of included studies. Studies that reported adherence to PRISMA guidelines on average scored higher on the AMSTAR tool (p=0.03). Conclusions The methodological quality of reviews about breast augmentation was found to be moderate, with no significant increase in studies or quality over time. Adherence to PRISMA guidelines and increased appraisal of SRs about breast augmentation using methodological assessment tools would further strengthen methodological quality and confidence in study findings.

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