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      • KCI등재후보SCOPUS

        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.

      • KCI등재후보SCOPUS

        Neoadjuvant chemoradiotherapy versus immediate surgery for resectable and borderline resectable pancreatic cancer: Meta-analysis and trial sequential analysis of randomized controlled trials

        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.

      • KCI등재

        Low versus standard central venous pressure during laparoscopic liver resection: A systematic review, meta-analysis and trial sequential analysis

        Mina Stephanos,Christopher M. B. Stewart,Ameen Mahmood,Christopher Brown,Shahin Hajibandeh,Shahab Hajibandeh,Thomas Satyadas 한국간담췌외과학회 2024 Annals of hepato-biliary-pancreatic surgery Vol.28 No.2

        To compare the outcomes of low central venous pressure (CVP) to standard CVP during laparoscopic liver resection. The study design was a systematic review following the PRISMA statement standards. The available literature was searched to identify all studies comparing low CVP with standard CVP in patients undergoing laparoscopic liver resection. The outcomes included intraoperative blood loss (primary outcome), need for blood transfusion, mean arterial pressure, operative time, Pringle time, and total complications. Random- effects modelling was applied for analyses. Type I and type II errors were assessed by trial sequential analysis (TSA). A total of 8 studies including 682 patients were included (low CVP group, 342; standard CVP group, 340). Low CVP reduced intraoperative blood loss during laparoscopic liver resection (mean difference [MD], –193.49 mL; 95% confidence interval [CI], –339.86 to –47.12; p = 0.01). However, low CVP did not have any effect on blood transfusion requirement (odds ratio [OR], 0.54; 95% CI, 0.28–1.03; p = 0.06), mean arterial pressure (MD, –1.55 mm Hg; 95% CI, –3.85–0.75; p = 0.19), Pringle time (MD, –0.99 minutes; 95% CI, –5.82–3.84; p = 0.69), operative time (MD, –16.38 minutes; 95% CI, –36.68–3.39; p = 0.11), or total complications (OR, 1.92; 95% CI, 0.97–3.80; p = 0.06). TSA suggested that the meta-analysis for the primary outcome was not subject to type I or II errors. Low CVP may reduce intraoperative blood loss during laparoscopic liver resection (moderate certainty); however, this may not translate into shorter operative time, shorter Pringle time, or less need for blood transfusion. Randomized controlled trials with larger sample sizes will provide more robust evidence.

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