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1.
M. Gawenda S. Said 《Langenbeck's archives of surgery / Deutsche Gesellschaft fur Chirurgie》1994,379(3):145-151
Zusammenfassung Laparoskopische Operationsmethoden gewannen in den vergangenen Jahren zunehmende Popularität in der Chirurgie. Die laparoskopische Cholezystektomie gilt inzwischen als etabliert. Im Gegensatz dazu ist die laparoskopische Appendektomie weiterhin umstritten. Mittels der computergestützten Literaturdatenbank Medline wurden sämtliche Veröffentlichungen bis zum 31.12.1993 zum Stichwort laparoskopische Appendektomie zusammengetragen. Von 90 Publikationen stellen lediglich 14 einen Vergleich zwischen konventioneller und laparoskopischer Appendektomie an. Lediglich zwei prospektiv randomiserte Studien wurden publiziert. Die geringen Kollektivgrößen lassen eine abschließende Bewertung der laparoskopischen Methode noch nicht zu.
Laparoscopic appendectomy — a review
Laparoscopic methods are becoming increasingly popular in surgery. In the course of a review concerning laparoscopic appendectomy undertaken up to 31 December 1993 all publications were evaluated by computer-assisted recherche. Out of a total of 90 publications only 14 deal with the comparison of the laparoscopic versus open appendectomy. Two prospective randomized studies are published. Because of the low number of patients the evaluation of the laparoscopic method is not yet definite.相似文献
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目的对现有椎体成形术与非手术治疗骨质疏松性椎体压缩性骨折(OVCF)安全性的随机对照研究(RCT)进行系统评价,从而为合理、科学地认识椎体成形术后椎体及相邻椎体再骨折提供统计学依据,并用于指导临床及下一步科研。方法全面检索所有关于椎体成形术与非手术治疗OVCF安全性的RCT文献,严格按照纳入及排除标准筛选文献,并对结果进行Meta分析。结果最终纳入7篇RCT文献,共计782名患者,其中椎体成形术组377名患者,非手术治疗组405名患者。Meta分析结果显示,椎体成形术组和非手术治疗组椎体及相邻椎体再骨折发生率在治疗后1、3、6、12和24个月差异均无统计学意义(P0.05)。结论本研究支持椎体及相邻椎体再骨折的发生可能是骨质疏松症的自然病程这一假说,不是椎体成形术的并发症,抗骨质疏松治疗能很好地降低此种风险。 相似文献
4.
Sanjay Pandanaboyana Devender Mittapalli Ahsan Rao Raj Prasad Niaz Ahmad 《The surgeon》2014,12(2):87-93
BackgroundThis metaanalysis was designed to systematically analyse all published randomized controlled trials comparing self-gripping mesh (ProGrip) and sutured mesh to analyse early and long term outcomes for open inguinal hernia repair.MethodsA literature search was performed using the Cochrane Colorectal Cancer Group Controlled Trials Register, the Cochrane Central Register of Controlled Trials in the Cochrane Library, MEDLINE, Embase and Science Citation Index Expanded. Randomized trials comparing self-gripping mesh with sutured mesh were included. Statistical analysis was performed using Review Manager Version 5.2 software. The primary outcome measures were hernia recurrence and chronic pain after operation. Secondary outcome measures included surgical time, wound complications and perioperative complications.ResultsFive randomized trials were identified as suitable, including 1170 patients. There was no significant difference between the two types of mesh repairs in perioperative complications, wound haematoma, chronic groin pain and hernia recurrence. Wound infection was lower in self gripping mesh group compared to sutured mesh but this was not statistically significant (risk ratio (RR) 0.57, 95% confidence interval 0.30–1.06, P = 0.08). The duration of operation was significantly shorter with self-gripping mesh compared to sutured mesh with a mean difference of ?5.48 min [?9.31, ?1.64] Z = 2.80 (P = 0.005).ConclusionSelf-gripping mesh was associated with shorter operative time compared to sutured mesh. Both types of mesh repairs have comparable perioperative and long term outcomes. 相似文献
5.
Nicolae-Catalin Mechie Christian Rver Silke Cameron Ahmad Amanzada 《World journal of hepatology》2014,6(10):759-765
AIM: To investigate the predictability of interleukin-28 B single nucleotide polymorphism rs12979860 with respect to sustained virological response(SVR) in chronically hepatitis C virus(HCV) genotype-1 patients treated with a protease-inhibitor and pegylated interferon-α(Peg-INF-α) based triple-therapy. METHODS: We searched PubMed, the Cochrane Library and Web of Knowledge for studies regarding the interleukin 28B(IL-28B)-genotype and protease-inhibitor based triple-therapy. Ten studies with 2707 patients were included into this meta-analysis. We used regression methods in order to investigate determinants of SVR.RESULTS: IL-28B-CC-genotype patients achieved higher SVR rates(odds 5.34, 95%CI: 3.81-7.49) than IL-28B-non-CC-genotype patients(1.88, 95%CI: 1.43-2.48) receiving triple-therapy. The line of therapy(treatment-nave or-experienced for Peg-INF-α) did not affect the predictive value of IL-28B(P = 0.1). IL-28BCC-genotype patients treated with protease inhibitorbased triple-therapy consisting of Boceprevir, Simeprevir, Telaprevir or Vaniprevir showed odds of 3.38, 14.66, 7.84 and 2.91, respectively. The odds for CC genotype patients treated with Faldaprevir cannot be quantified, as only a single study with a 100% SVR rate was available.CONCLUSION: IL-28B-SNP predicts the outcome for chronic HCV genotype-1 patients receiving protease inhibitor-based triple-therapy. The predictive value varies between the different protease inhibitors. 相似文献
6.
GA Antoniou D Murray SA Antoniou G Kuhan F Serracino-Inglott 《Annals of the Royal College of Surgeons of England》2014,96(3):184-189
Introduction
The retrojugular approach for carotid endarterectomy (CEA) has been reported to have the advantages of shorter operative time and ease of dissection, especially in high carotid lesions. Controversial opinion exists with regard to its safety and benefits over the conventional antejugular approach.Methods
A systematic review of electronic information sources was conducted to identify studies comparing outcomes of CEA performed with the retrojugular and antejugular approach. Synthesis of summary statistics was undertaken and fixed or random effects models were applied to combine outcome data.Findings
A total of 6 studies reporting on a total of 740 CEAs (retrojugular approach: 333 patients; antejugular approach: 407 patients) entered our meta-analysis models. The retrojugular approach was found to be associated with a higher incidence of laryngeal nerve damage (odds ratio [OR]: 3.21, 95% confidence interval [CI]: 1.46–7.07). No significant differences in the incidence of hypoglossal or accessory nerve damage were identified between the retrojugular and antejugular approach groups (OR: 1.09 and 11.51, 95% CI: 0.31–3.80 and 0.59–225.43). Cranial nerve damage persisting during the follow-up period was similar between the groups (OR: 2.96, 95% CI: 0.79–11.13). Perioperative stroke and mortality rates did not differ in patients treated with the retrojugular or antejugular approach (OR: 1.26 and 1.28, 95% CI: 0.31–5.21 and 0.25–6.50).Conclusions
Currently, there is no conclusive evidence to favour one approach over the other. Proof from a well designed randomised trial would help determine the role and benefits of the retrojugular approach in CEA. 相似文献7.
目的系统评价阿托伐他汀调节中老年2型糖尿病患者低密度脂蛋白胆固醇(LDL-C)及载脂蛋白B(apoB)的效果。方法计算机检索PubMed(1990~2009),Cochrane Library(1990~2010),Elsevier(2000~2010),维普(1989~2010),中国生物医学文献数据库(2000~2010),中国学术期刊全文数据库(1990~2010),万方数据库(1990~2010),手工检索中华糖尿病杂志(2001~2010),中华内分泌代谢杂志(2001~2010)。按纳入与排除标准选择随机对照试验(RCT)。评价质量及提取资料后,采用RevMan 5.0.1软件对数据进行Meta分析。结果共纳入4项随机对照试验中的3171例糖尿病患者,Meta分析结果显示阿托伐他汀可使中老年2型糖尿病患者LDL-C下降[WMD=-1.00,95%CI(-1.37~-0.64),P<0.01]。阿托伐他汀组较安慰剂组apoB下降[WMD=-0.34,95%CI(-0.50~-0.17),P<0.01]。结论中老年2型糖尿病患者长期服用小剂量的阿托伐他汀有助调节LDL-C及apoB代谢,改善脂代谢紊乱。 相似文献
8.
目的评价术前腔内支架治疗左半结肠和直肠癌肠梗阻的安全性与有效性。方法利用CENTRAL、PubMed、EMBASE、Medline、OvidLww等英文数据库和CMB、CNKI、万方等中文数据库.全面检索术前腔内支架与急诊手术治疗左半结肠和直肠癌肠梗阻的比较研究的中英文随机对照试验和回顾性分析文献.利用RevMan5.1软件对两种治疗方法的安全性和有效性指标进行Meta分析。结果最终纳入14篇文献共1083例患者,其中随机对照研究5篇,回顾性分析9篇。与急诊手术相比,术前腔内支架组围手术期死亡率(RR:O.52;95%CI:0.30-0.93。P〈0.05)和总并发症发生率降低(RR=0.46,95%U:0.31-0.70,P〈0.01),手术切除率提高(RR:1.90,95%U:1.33-2.70,P〈0.01),手术时间(MD=-59.77,95%CI:-87.51-32.04.P〈0.01)和术后排气时间缩短(MD=一10.78,95%CI:-16.67-4.90,P〈0.01):两种方法的永久造瘘率和住院时间的差异则无统计学意义(均P〉0.05)。结论术前腔内支架治疗左半结肠和直肠癌肠梗阻的安全性和有效性均优于急诊手术。 相似文献
9.
目的比较加替沙星片与左氧氟沙星片治疗急性细菌性感染的疗效。方法应用meta分析对有关加替沙星和左氧氟沙星治疗急性细菌性感染的临床疗效及细菌清除率进行定量综合分析,共入选10篇文献,可进行临床疗效评价病例992例。可进行细菌清除率比较病例1072例。结果同质性检验:细菌清除率比较,x^2=7.82,P=0.45;临床有效率比较,x^2=4.19,P=0.84;临床痊愈率比较,x^2=4.59,P=0.71;合并效应量的估计:细菌清除率比较,OR合并=0.98(0.63~1.53,Z=0.09,P=0.93);临床有效率比较,OR合并=1.29(0.80~2.10,Z=1.04,P=0.30);临床痊愈率比较。OR合井=1.21(0.89~1.63,Z=1.22。P=0.22)。结论国产加替沙星片与左氧氟沙星在治疗急性细菌性感染疾病的疗效相等。 相似文献
10.
目的 比较吡柔比星与其他灌注化疗药物预防膀胱肿瘤复发的疗效. 方法检索Medline、EMBase、CBMDisc等文摘数据库以及PubMed、ScienceDirect、Lww、Springer、中国期刊全文数据库、中文科技期刊数据库等全文数据库,收集并按照纳入和排除标准筛选已发表的关于吡柔比星与其他膀胱灌注化疗药物预防膀胱肿瘤术后复发疗效比较的对照研究,提取纳入研究中关于复发的数据进行Meta分析. 结果共获得15个符合标准的研究.其中10个研究比较了吡柔比星和丝裂霉素的疗效,Meta分析显示,吡柔比星预防膀胱肿瘤复发的疗效显著优于丝裂霉素(OR=0.41,95%CI0.27~0.61,P<0.01);6个研究分别比较了吡柔比星与噻替哌(OR=0.35,95%CI 0.11~1.13,P>0.05)、阿霉素(OR=0.15,95%CI 0.03~0.76,P<0.05)、表阿霉素(OR=0.53,95%CI 0.23~1.23,P>0.05)、羟基喜树碱(OR=0.25,95%CI 0.10~0.64,P<0.05)等药物以及空白对照组的疗效,统计学分析显示吡柔比星疗效显著优于羟基喜树碱、阿霉素以及空白对照组,而与噻替哌和表阿霉素疗效的差异无统计学意义. 结论吡柔比星能有效预防膀胱肿瘤术后复发,其疗效优于丝裂霉素、羟基喜树碱、阿霉素等药物,是新的可选择的膀胱肿瘤灌注化疗药物. 相似文献