Search

Background: Laparoscopic holmium laser lithotripsy (LHLL) has been used to treat bile duct stones with unclear outcomes. A meta-analysis was conducted to investigate the LHLL and laparoscopic bile duct exploration (LBDE) efficacy and safety in treating bile duct stones. Methods: The correlational studies were searched databases, such as PubMed, Embase, Cochrane Library, Web of Science, CNKI, Wanfang, and VIP, to identify eligible studies from inception to July 2022. The dichotomous and continuous outcomes were evaluated using odds ratio (OR), risk difference (RD) and weighted mean difference (WMD) with 95% confidence intervals (CIs). Stata 15.0 and Review Manager 5.3 software helped in data analyses. Results: A total of 23 studies with 1,890 patients, primarily from China, were included. The results indicated that operation time (WMD = − 26.94; 95% CI:(− 34.30, − 19.58); P < 0.00001), estimated blood loss (WMD = − 17.97; 95% CI: (− 22.94, − 13.00); P = 0.002), rate of residual stone (OR = 0.15, 95%CI: (0.10, 0.23); P < 0.00001), length of hospital stay (WMD = − 2.88; 95% CI:(− 3.80, − 1.96); P < 0.00001) and time to bowel function recovery (WMD = − 0.59; 95% CI: (− 0.76, − 0.41); P < 0.00001) had statistically significant differences between the two groups. In postoperative complications, biliary leakage (RD = -0.03; 95% CI: (− 0.05, -0.00); P = 0.02), infection (RD = − 0.06; 95% CI: (− 0.09,− 0.03); P < 0.00001) and Hepatic injury (RD = − 0.06; 95% CI: (− 0.11, − 0.01); P = 0.02) revealed statistically significant differences. However, no significant differences were observed in biliary damage (RD = − 0.03; 95% CI: (− 0.06, 0.00); P = 0.06) and hemobilia (RD = − 0.03; 95% CI: (− 0.06, 0.00); P = 0.08). Conclusion: The current meta-analysis indicated that LHLL could be more effective and safer than LBDC. However, these results should be confirmed with a larger sample size and rigorously designed randomized controlled trials. [ABSTRACT FROM AUTHOR]

Purpose: Evidence from several cohorts has suggested that a higher intake of isoflavone is associated with lower risk of lung cancer in never smokers, but the association has not been investigated by histologic type of lung cancer. Adenocarcinoma is a common histologic type found in never smokers. We hypothesized that a higher intake of isoflavone is associated with a lower risk of lung adenocarcinoma among never smokers. Here, we examined the associations of isoflavone and soy food intake with lung cancer and its histologic types in never smokers. Methods: We performed a pooled analysis using data from the Japan Public Health Center-based Prospective Study, Shanghai Women's Health Study and Shanghai Men's Study with 147,296 never smokers aged 40–74 years with no history of cancer. During 1,990,040 person-years of follow-up, 1247 lung cancer cases were documented. Dietary isoflavone and soy food intake were assessed using a food-frequency questionnaire. Multivariable Cox proportional hazards models assessed the associations between isoflavone and soy intake with incidence of lung cancer by histologic type. Results: A higher intake of dietary isoflavone and soy food were associated with reduced risk of lung adenocarcinoma. The multivariable hazard ratios (HRs) (95% CI) of risk of lung adenocarcinoma for the highest versus lowest intakes of isoflavone and soy food were 0.74 (0.60–0.92) and 0.78 (0.63–0.96), respectively. The multivariable HRs of risk of lung adenocarcinoma associated with each 10 mg/day increase in isoflavone and each 50 g/day increase in soy food intake were 0.81 (0.70–0.94) and 0.84 (0.73–0.96), respectively. Conclusion: Higher intake of isoflavone and soy food was associated with lower risk of lung adenocarcinoma in never smokers. [ABSTRACT FROM AUTHOR]