Dataset Information

LigaSure versus Conventional Parotidectomy: A Systematic Review and Meta-Analysis.

ABSTRACT: Surgery with parotidectomy is the preferable treatment for most parotid tumors. Our meta-analysis compared the differences between the use of the LigaSure (LS) device and the conventional suture ligation technique (CT) in parotidectomies. A literature search in databases including EMBASE, MEDLINE, and the Cochrane Library was carried out. Studies including parotidectomy using LS and CT were included with the intraoperative and postoperative parameters collected. Continuous operative time data were measured by mean differences (MDs). Discrete data on postoperative complications, including facial palsy, postoperative bleeding, and salivary complications, were evaluated with risk differences (RDs). All values were reported with 95% confidence intervals (CIs). Five studies were included in our meta-analysis. The pooled analysis demonstrated a significant reduction in operative time in the LS group (MD: -21.92; 95% CI, -30.18 to -13.66). In addition, the analysis indicated that the incidence of postoperative complications, including permanent facial palsy (RD, -0.01; 95% CI, -0.06 to 0.05), temporary facial palsy (RD, 0.00; 95% CI, -0.03 to 0.04), salivary complications (RD, -0.01; 95% CI, -0.08 to 0.06), and postoperative bleeding (RD, -0.02; 95% CI, -0.07 to 0.04), were all similar between the LS group and the CT group. According to the results, the LS device appears to be a safe and useful tool and could shorten the operative time in patients needing parotidectomy.

SUBMITTER: Chen SW

PROVIDER: S-EPMC9027715 | biostudies-literature | 2022 Apr

REPOSITORIES: biostudies-literature

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LigaSure versus Conventional Parotidectomy: A Systematic Review and Meta-Analysis.

Chen Sonia Wei-Ting SW Hsin Li-Jen LJ Lin Wan-Ni WN Tsai Yao-Te YT Tsai Ming-Shao MS Lee Yi-Chan YC

Healthcare (Basel, Switzerland) 20220411 4

Surgery with parotidectomy is the preferable treatment for most parotid tumors. Our meta-analysis compared the differences between the use of the LigaSure (LS) device and the conventional suture ligation technique (CT) in parotidectomies. A literature search in databases including EMBASE, MEDLINE, and the Cochrane Library was carried out. Studies including parotidectomy using LS and CT were included with the intraoperative and postoperative parameters collected. Continuous operative time data we ...[more]

PMID: 35455883

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Project description:ObjectiveA meta-analysis of randomized controlled trials was performed to compare the effects of miniaturized extracorporeal circulation (MECC) and conventional extracorporeal circulation (CECC) on morbidity and mortality rates after cardiac surgery.MethodsA comprehensive literature search was conducted using Ovid, PubMed, Medline, EMBASE, and the Cochrane databases. Randomized controlled trials from the year 2000 with n > 40 patients were considered. Key search terms included variations of "mini," "cardiopulmonary," "bypass," "extracorporeal," "perfusion," and "circuit." Studies were assessed for bias using the Cochrane Risk of Bias tool. The primary outcomes were postoperative mortality and stroke. Secondary outcomes included arrhythmia, myocardial infarction, renal failure, blood loss, and a composite outcome comprised of mortality, stroke, myocardial infarction and renal failure. Duration of intensive care unit, and hospital stay was also recorded.ResultsThe 42 studies eligible for this study included a total of 2154 patients who underwent CECC and 2196 patients who underwent MECC. There were no significant differences in any preoperative or demographic characteristics. Compared with CECC, MECC did not reduce the incidence of mortality, stroke, myocardial infarction, and renal failure but did significantly decrease the composite of these outcomes (odds ratio, 0.64; 95% confidence interval [CI], 0.50-0.81; P = .0002). MECC was also associated with reductions in arrhythmia (odds ratio, 0.67; 95% CI, 0.54-0.83; P = .0003), blood loss (mean difference [MD], -96.37 mL; 95% CI, -152.70 to -40.05 mL; P = .0008), hospital stay (MD, -0.70 days; 95% CI, -1.21 to -0.20 days; P = .006), and intensive care unit stay (MD, -2.27 hours; 95% CI, -3.03 to -1.50 hours; P < .001).ConclusionsMECC demonstrates clinical benefits compared with CECC. Further studies are required to perform a cost-utility analysis and to assess the long-term outcomes of MECC. These should use standardized definitions of endpoints such as mortality and renal failure to reduce inconsistency in outcome reporting.

Project description:Robotic-assisted mitral valve surgery (RMVS) is becoming an increasingly performed procedure in cardiac surgery, however, its true safety and efficacy compared to the gold standard conventional sternotomy approach [conventional sternotomy mitral valve surgery (CSMVS)] remains debated. The aim of this meta-analysis was to provide a comprehensive analysis of all available literature comparing RMVS to CSMVS. An electronic search of five databases was performed to identify all relevant studies comparing RMVS to CSMVS. Pre-defined primary outcomes of interest included all-cause mortality, cerebrovascular accidents (CVA) and re-operation for bleeding. Secondary outcomes of interest included cross clamp time, cardiopulmonary bypass (CPB) time, intensive care unit (ICU) and hospital length of stay (LOS), post-operative atrial fibrillation (POAF) and red blood cell (RBC) transfusion. The search strategy identified fourteen studies qualifying for inclusion in this meta-analysis comparing RMVS to CSMVS. The outcomes of 6,341 patients (2,804 RMVS and 3,537 CSMVS) were included. RMVS had significantly lower mortality when compared to CSMVS group in both the unmatched [odds ratio (OR) 0.33; 95% confidence interval (CI): 0.19-0.57; P<0.001] and matched cohorts (OR 0.35; 95% CI: 0.15-0.80; P=0.01). There was no significant difference in rates of CVA or re-operation for bleeding between the two groups in either the entire included cohort or matched patients. CSMVS had significantly shorter cross clamp time by 28 minutes (95% CI: 19.30-37.32; P<0.001) and CPB time by 49 minutes (95% CI: 36.16-61.01; P<0.001) which remained significantly shorter in the matched cohorts. RMVS had shorter ICU [mean difference (MD) 26 hours; 95% CI: -34.31 to -18.52; P<0.001] and hospital LOS (MD 2 days; 95% CI: -2.66 to -1.37; P<0.001), which were again both significantly shorter in the matched cohort. RMVS group also had fewer RBC transfusions (OR 0.44; 95% CI: 0.28-0.70; P<0.001). Current evidence on comparative outcomes of RMVS and CSMVS is limited with only low-quality studies currently available. This present meta-analysis suggests that RMVS may have lower mortality and shorter ICU and hospital LOS, however CSMVS may be associated with significantly shorter cross clamp and CPB times. Further analysis of high-quality studies with randomized data is required to verify these results.

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Dataset Information

LigaSure versus Conventional Parotidectomy: A Systematic Review and Meta-Analysis.

Publications

LigaSure versus Conventional Parotidectomy: A Systematic Review and Meta-Analysis.

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