Implant Stability of Osseodensification Drilling Versus Conventional Surgical Technique: A Systematic Review

2021 ◽  
Vol 36 (6) ◽  
pp. 1104-1110
Author(s):  
João Gaspar ◽  
Luís Proença ◽  
João Botelho ◽  
Vanessa Machado ◽  
Leandro Chambrone ◽  
...  
Keyword(s):  
Systematic Review ◽  
Surgical Technique ◽  
Implant Stability

P–004 Effect of varicocelectomy on sperm DNA fragmentation rates in infertile men with clinical varicocele: a systematic review and meta-analysis

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
F Tenori. Lir. Neto ◽  
M Roque ◽  
S Esteves
Keyword(s):  
Systematic Review ◽  
Surgical Technique ◽  
Dna Fragmentation ◽  
Subgroup Analysis ◽  
Meta Analysis ◽  
Sperm Dna Fragmentation ◽  
Inclusion Criteria ◽  
Infertile Men ◽  
Sperm Dna ◽  
The Impact

Abstract Study question Does varicocelectomy improve sperm DNA quality in men with infertility and clinically detected varicoceles? Summary answer Varicocelectomy reduces sperm DNA fragmentation (SDF) rates in infertile men with clinical varicocele. What is known already Varicocele has been linked to male infertility through various non-mutually exclusive mechanisms, including an increase in reactive oxygen species (ROS) production that may lead to sperm DNA damage. Damage to sperm DNA may result in longer time-to-pregnancy, unexplained infertility, recurrent pregnancy loss, and failed intrauterine insemination or in vitro fertilization/intracytoplasmic sperm injection. Therefore, interventions aimed at decreasing SDF rates, including varicocele repair, have been explored to improve fertility and pregnancy outcomes potentially, either by natural conception or using medically assisted reproduction. Study design, size, duration Systematic review and meta-analysis Participants/materials, setting, methods We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Our systematic search included PubMed/Medline, EMBASE, Scielo, and Google Scholar to identify all relevant studies written in English and published from inception until October 2020. Inclusion criteria were studies comparing SDF rates before and after varicocelectomy in infertile men with clinical varicocele. Articles were included if the following SDF assays were utilized: SCSA, TUNEL, SCD test, or alkaline Comet. Main results and the role of chance Thirteen studies fulfilled the inclusion criteria and were selected for the analysis. The estimated weighted mean difference of SDF rates after varicocelectomy was –6.58% (13 studies, 95% CI –8.33%, –4.84%; I2=90% p < 0.0001). Subgroup analysis revealed a significant decrease in SDF rates using SCSA (eight studies, WMD –6.80%, 95% CI –9.31%, –4.28%; I2=89%, p < 0.0001), and TUNEL (three studies, WMD –4.86%, 95% CI –7.38%, –2.34%; I2=89%, p < 0.0001). The test for subgroup difference revealed that pooled results were conservative using the above SDF assays. Comet and SCD tests were used in only one study each; thus, a meta-analysis was not applicable. The studies were further categorized by the surgical technique (microsurgical versus non-microsurgical). This subgroup analysis showed a significant decrease in SDF rates using microsurgical technique (10 studies, WMD –6.70%, 95% CI –9.04%, –4.37%; I2=91%, p < 0.0001). After varicocelectomy, SDF rates were also decreased when non-microsurgical approaches were used, albeit the effect was not statistically significant (2 studies, WMD –6.84%, 95% CI –10.05%, 1.38%; I2=86%) (Figure 3). The heterogeneity was not materially affected by performing analyses by the above subgroups, suggesting that the SDF assay and surgical technique do not explain the inconsistency in the treatment effect across primary studies. Limitations, reasons for caution There were no randomized controlled trials comparing varicocelectomy to placebo for alleviating SDF levels. Heterogeneity was high, which may be explained by the low number of included studies. Pregnancy data are not available in most studies, thus the impact of reduced SDF after varicocelectomy on pregnancy rates unclear. Wider implications of the findings: Our study indicates a positive association between varicocelectomy and reduced postoperative SDF rates in men with clinical varicocele and infertility, independentetly of the assays used to measure SDF. These findings may help counsel and manage infertile men with varicocele and high SDF levels. Trial registration number Not applicable

scholarly journals Tracheal and Cricotracheal Resection With End-to-End Anastomosis for Locally Advanced Thyroid Cancer: A Systematic Review of the Literature on 656 Patients

2021 ◽  
Vol 12 ◽  
Author(s):  
Cesare Piazza ◽  
Davide Lancini ◽  
Michele Tomasoni ◽  
Anil D’Cruz ◽  
Dana M. Hartl ◽  
...  
Keyword(s):  
Systematic Review ◽  
Surgical Technique ◽  
Primary Anastomosis ◽  
Recurrent Laryngeal Nerve Palsy ◽  
Locally Advanced ◽  
Survival Rates ◽  
Oncologic Outcomes ◽  
Tracheal Resection ◽  
Clinical Issue ◽  
Airway Invasion

Airway involvement by advanced thyroid carcinoma (TC) constitutes a negative prognosticator, besides being a critical clinical issue since it represents one of the most frequent causes of death in locally advanced disease. It is generally agreed that, for appropriate laryngo-tracheal patterns of invasion, (crico-)tracheal resection and primary anastomosis [(C)TRA] is the preferred surgical technique in this clinical scenario. However, the results of long-term outcomes of (C)TRA are scarce in the literature, due to the rarity of such cases. The relative paucity of data prompts careful review of the available relevant series in order to critically evaluate this surgical technique from the oncologic and functional points of view. A systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement on the PubMed, Scopus, and Web of Science databases. English-language surgical series published between January 1985 and August 2021, reporting data on ≥5 patients treated for TC infiltrating the airway by (C)TRA were included. Oncologic outcomes, mortality, complications, and tracheotomy-dependency rates were assessed. Pooled proportion estimates were elaborated for each end-point. Thirty-seven studies were included, encompassing a total of 656 patients. Pooled risk of perioperative mortality was 2.0%. Surgical complications were reported in 27.0% of patients, with uni- or bilateral recurrent laryngeal nerve palsy being the most common. Permanent tracheotomy was required in 4.0% of patients. Oncologic outcomes varied among different series with 5- and 10-year overall survival rates ranging from 61% to 100% and 42.1% to 78.1%, respectively. Five- and 10-year disease specific survival rates ranged from 75.8% to 90% and 54.5% to 62.9%, respectively. Therefore, locally advanced TC with airway invasion treated with (C)TRA provides acceptable oncologic outcomes associated with a low permanent tracheotomy rate. The reported incidence of complications, however, indicates the need for judicious patient selection, meticulous surgical technique, and careful postoperative management.

Robotic Nephrectomy for Living Donation: Surgical Technique and Literature Systematic Review.

2014 ◽  
Vol 98 ◽  
pp. 131
Author(s):  
A. Giacomoni ◽  
S. Di Sandro ◽  
A. Lauterio ◽  
G. Concone ◽  
P. Mihaylov ◽  
...  
Keyword(s):  
Systematic Review ◽  
Surgical Technique ◽  
Living Donation ◽  
Robotic Nephrectomy

A comparison between endoscopic and microscopic approaches for stapes surgery: a systematic review

2020 ◽  
Vol 134 (5) ◽  
pp. 398-403 ◽  
Author(s):  
H F Pauna ◽  
R C Pereira ◽  
R C Monsanto ◽  
M S A Amaral ◽  
M A Hyppolito
Keyword(s):  
Systematic Review ◽  
Surgical Technique ◽  
Web Of Science ◽  
Surgical Techniques ◽  
Stapes Surgery ◽  
Less Invasive Surgery ◽  
Microscopic Approach ◽  
Microscopic Surgery ◽  
Hearing Outcomes ◽  
Microscopic Techniques

AbstractObjectivesTo evaluate the surgical techniques, approaches, audiological outcomes and complications of endoscopic stapes surgery.MethodsSystematic searches of the literature were performed in PubMed, Web of Science and Scopus databases, to identify studies of patients who underwent stapes surgery using endoscopic approaches and studies reporting objective post-operative hearing outcomes. The following information was extracted: surgery duration, complications, surgical technique and audiometric results.ResultsFourteen studies were selected for appraisal, which included a total of 282 ears subjected to endoscopic stapes surgery. Endoscopic stapes surgery seems to provide adequate visualisation of the middle-ear structures, thereby allowing less invasive surgery and potentially equivalent audiological outcomes as compared with a traditional microscopic approach. Other advantages of endoscopic stapes surgery include decreased surgery time, a reduced need for drilling, and auditory results comparable to those of microscopic techniques.ConclusionStudies have shown that endoscopic stapes surgery has similar surgical and functional advantages as compared with microscopic surgery.

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