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- 저자 : Thomas Satyadas (검색결과 2 건)
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Procedural outcomes of laparoscopic caudate lobe resection: A systematic review and meta-analysis
Shahab Hajibandeh,Ahmed Kotb,Louis Evans,Emily Sams,Andrew Naguib,Shahin Hajibandeh,Thomas Satyadas 한국간담췌외과학회 2023 Annals of hepato-biliary-pancreatic surgery Vol.27 No.1
A systematic review was conducted in compliance with PRISMA statement standards to identify all studies reporting outcomes of laparoscopic resection of benign or malignant lesions located in caudate lobe of liver. Pooled outcome data were calculated using random-effects models. A total of 196 patients from 12 studies were included. Mean operative time, volume of intraoperative blood loss, and length of hospital stay were 225 minutes (95% confidence interval [CI], 181–269 minutes), 134 mL (95% CI, 85–184 mL), and 7 days (95% CI, 5–9 days), respectively. The pooled risk of need for intraoperative transfusion was 2% (95% CI, 0%–5%). It was 3% (95% CI, 1%–6%) for conversion to open surgery, 6% (95% CI, 0%–19%) for need for intra-abdominal drain, 1% (95% CI, 0%–3%) for postoperative mortality, 2% (95% CI, 0%–4%) for biliary leakage, 2% (95% CI, 0%–4%) for intra-abdominal abscess, 1% (95% CI, 0%–4%) for biliary stenosis, 1% (95% CI, 0%–3%) for postoperative bleeding, 1% (95% CI, 0%–4%) for pancreatic fistula, 2% (95% CI, 1%–5%) for pulmonary complications, 1% (95% CI, 0%–4%) for paralytic ileus, and 1% (95% CI, 0%–4%) for need for reoperation. Although the available evidence is limited, the findings of the current study might be utilized for hypothesis synthesis in future studies. They can be used to inform surgeons and patients about estimated risks of perioperative complications until a higher level of evidence is available.
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Shahab Hajibandeh,Shahin Hajibandeh,Christina Intrator,Karim Hassan,Mantej Sehmbhi,Jigar Shah,Eshan Mazumdar,Ambareen Kausar,Thomas Satyadas 한국간담췌외과학회 2023 Annals of hepato-biliary-pancreatic surgery Vol.27 No.1
We aimed to compare resection and survival outcomes of neoadjuvant chemoradiotherapy (CRT) and immediate surgery in patients with resectable pancreatic cancer (RPC) or borderline resectable pancreatic cancer (BRPC). In compliance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement standards, a systematic review of randomized controlled trials (RCTs) was conducted. Random effects modeling was applied to calculate pooled outcome data. Likelihood of type 1 or 2 errors in the meta-analysis model was assessed by trial sequential analysis. A total of 400 patients from four RCTs were included. When RPC and BRPC were analyzed together, neoadjuvant CRT resulted in a higher R0 resection rate (risk ratio [RR]: 1.55, p = 0.004), longer overall survival (mean difference [MD]: 3.75 years, p = 0.009) but lower overall resection rate (RR: 0.83, p = 0.008) compared with immediate surgery. When RPC and BRPC were analyzed separately, neoadjuvant CRT improved R0 resection rate (RR: 3.72, p = 0.004) and overall survival (MD: 6.64, p = 0.004) of patients with BRPC. However, it did not improve R0 resection rate (RR: 1.18, p = 0.13) or overall survival (MD: 0.94, p = 0.57) of patients with RPC. Neoadjuvant CRT might be beneficial for patients with BRPC, but not for patients with RPC. Nevertheless, the best available evidence does not include contemporary chemotherapy regimens. Patients with RPC and those with BRPC should not be combined in the same cohort in future studies.
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