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Objective: To compare the postoperative complications of intracorporeal anastomosis (ICA) and extracorporeal anastomosis (ECA) in patients undergoing laparoscopic right colectomy (LRC).Background: Although several studies have compared postoperative complications of ICA and ECA after LRC, most were retrospective studies.Methods: We performed a comprehensive electronic search of the literature to identify studies that compared postoperative complications between ICA and ECA in patients who underwent LRC. We performed meta-analysis using random-effects models to calculate the risk ratio (RR) and 95% confidence interval (CI) of experiencing complications, and we analyzed heterogeneity using I2 statistics.Results: Fifteen studies consist of randomized controlled trials, case-control studies, and propensity score matching studies involving a total of 3219 patients who underwent LRC were included. Among 1377 patients who received ICA, 255 (18.5%) had postoperative complications, whereas among 1652 patients who received ECA, 373 (22.6%) had such complications. The results of the meta-analysis revealed that ICA was associated with a significantly reduced risk of postoperative complications (RR, .73; 95% CI: .57-.95; P = .02; I2 = 57%) compared with ECA. Although there was no significant difference between the 2 groups in risk of anastomotic leakage (RR, .67; 95% CI: .39-1.17; P = .16; I2 = 8%), there was a significant difference between them in risk of surgical site infection (RR, .50; 95% CI: .34-.71; P = .0002; I2 = 0%).Conclusions: Intracorporeal anastomosis is associated with a reduced risk of postoperative complications compared with ECA in patients undergoing LRC. [ABSTRACT FROM AUTHOR]

Background: Recent retrospective subgroup analyses of patients with unresectable colon cancer (CC) receiving systemic chemotherapy have demonstrated that there is a significant difference in treatment outcome between patients with right‐sided CC (RSCC) and those with left‐sided CC (LSCC). However, it is impossible to divide patients with CC randomly into RSCC and LSCC groups before surgery. Therefore, the aim of this study is to explore the impact of primary tumor location (PTL) on survival after curative surgery for patients with CC using propensity score‐matching (PSM) studies instead of randomization. Materials and Methods: We performed a comprehensive electronic search of the literature up to January 2019 to identify studies that had used databases allowing comparison of postoperative survival between patients with RSCC and those with LSCC. To integrate the impact of PTL on 5‐year overall survival (OS) after curative surgery, a meta‐analysis was performed using random‐effects models to calculate the risk ratio (RR) and 95% confidence interval (CI) for the selected PSM studies. Results: Five studies involving a total of 398,687 patients with CC were included in this meta‐analysis. Among 205,641 patients with RSCC, 69,091 (33.6%) died during the observation period, whereas among 193,046 patients with LSCC, 63,380 (32.8%) died during the same period. These results revealed that patients with RSCC and those with LSCC had almost the same 5‐year OS (RR, 0.98; 95% CI, 0.89–1.07; p =.64; I2 = 97%). Conclusion: This meta‐analysis has demonstrated that there was no significant difference in 5‐year OS between patients with RSCC and those with LSCC after curative resection. Implications for Practice: To integrate the impact of primary tumor location (PTL) on 5‐year overall survival (OS) after curative surgery, five propensity score‐matching (PSM) studies involving a total of 398,687 patients with colon cancer (CC) were included in this meta‐analysis. Among 205,641 patients with right‐sided CC (RSCC), 69,091 (33.6%) died during the observation period, whereas among 193,046 patients with left‐sided CC (LSCC), 63,380 (32.8%) died during the same period. These results revealed that patients with RSCC and those with LSCC had almost the same 5‐year OS (risk ratio, 0.98; 95% confidence interval, 0.89–1.07; p =.64; I2 = 97%). There is a significant difference in treatment outcomes for patients with right‐sided versus left‐sided colon cancer. This study explored the effect of primary tumor location on survival after curative surgery using propensity score‐matching studies instead of randomized studies. [ABSTRACT FROM AUTHOR]

Background: Small bowel obstruction (SBO) is a well‐known major postoperative complication requiring immediate diagnosis and treatment to avoid additional invasive surgical procedures. Water‐soluble contrast medium is often given not only for diagnosis but also for treatment. Although numerous studies have investigated the significance of this treatment, no consensus has yet been established regarding its indications and efficacy. Objective: To explore whether Gastrografin can reduce the need for additional surgery in patients with postoperative SBO (PSBO). Methods: We carried out a comprehensive electronic search of the literature (Cochrane Library, MEDLINE, PubMed and the Web of Science) up to February 2017 to identify studies that had shown efficacy of Gastrografin in reducing the need for surgery in patients with PSBO. To integrate the individual effects of Gastrografin, a meta‐analysis was done using random‐effects models to calculate the risk ratio (RR) and 95% confidence interval (CI), and heterogeneity was analyzed using I2 statistics. Results: Twelve studies involving a total of 1153 patients diagnosed as having PSBO were included in this meta‐analysis. Not all patients received long‐tube insertion. Among 580 patients who received Gastrografin, 100 (17.2%) underwent surgery, whereas among 573 patients who did not receive Gastrografin, 143 (25.0%) underwent surgery. Giving Gastrografin significantly reduced the need for surgery (RR, 0.66; 95% CI, 0.46‐0.95; P = 0.02; I2 = 52%) in comparison with patients who did not receive Gastrografin. Conclusion: Results of this meta‐analysis show that giving Gastrografin reduces the need for surgery in PSBO patients without long‐tube insertion. Gastrografin reduces the need for additional surgery in patients with postoperative small bowel obstruction. [ABSTRACT FROM AUTHOR]

Objective: To explore the impact of appendectomy history on emergence of Parkinson's disease (PD).Background: Although there are several studies to investigate the relationship between appendectomy history and emergence of PD, the results are still controversial.Methods: We performed a comprehensive electronic search of the literature (the Cochrane Library, PubMed, and the Web of Science) up to April 2020 to identify studies that had employed databases allowing comparison of emergence of PD between patients with and those without appendectomy history. To integrate the impact of appendectomy history on emergence of PD, a meta-analysis was performed using random-effects models to calculate the risk ratio (RR) and 95% confidence interval (CI) for the selected studies, and heterogeneity was analyzed using I2 statistics.Results: Four studies involving a total of 6 080 710 patients were included in this meta-analysis. Among 1 470 613 patients with appendectomy history, 1845 (.13%) had emergences of PD during the observation period, whereas among 4 610 097 patients without appendectomy history, 6743 (.15%) had emergences of PD during the observation period. These results revealed that patients with appendectomy history and without appendectomy had almost the same emergence of PD (RR, 1.02; 95% CI, .87-1.20; P = .83; I2 = 87%).Conclusion: This meta-analysis has demonstrated that there was no significant difference in emergence of PD between patients with and those without appendectomy history. [ABSTRACT FROM AUTHOR]

Aim: Although it has been widely demonstrated that administration of Daikenchuto (DKT), a traditional Japanese herbal medicine, improves gastrointestinal (GI) motility in patients undergoing abdominal surgery, few studies have investigated the efficacy of perioperative DKT administration for relief of postoperative ileus (PI) in patients undergoing surgery for GI cancer. Therefore, the aim of this study was to investigate whether perioperative administration of DKT relieves PI in patients with GI cancer., Patients and Methods: We performed a comprehensive electronic search of the literature (Cochrane Library, PubMed, the Web of Science and ICHUSHI) up to December 2016 to identify studies that had shown the efficacy of perioperative DKT administration for relief of PI in patients with GI cancer. To integrate the individual effect of DKT, a meta-analysis was performed using random-effects models to calculate the risk ratio (RR) and 95% confidence interval (CI), and heterogeneity was analyzed using I 2 statistics., Results: Seven studies involving a total of 1,134 patients who had undergone GI cancer surgery were included in this meta-analysis. Among 588 patients who received DKT perioperatively, 67 (11.4%) had PI, whereas among 546 patients who did not receive DKT perioperatively, 87 (15.9%) had PI. Perioperative administration of DKT significantly reduced the occurrence of PI (RR=0.58, 95% CI=0.35-0.97, p=0.04, I 2 =48%) in comparison to patients who did not receive DKT or received placebo., Conclusion: The result of this meta-analysis suggests that perioperative administration of DKT relieves PI in patients undergoing surgery for GI cancer., (Copyright© 2017, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.)

Uni- and multivariate analyses were performed in order to assess the most valuable clinical features that were associated with the overall survival of 169 patients who underwent surgery for stage IV colorectal cancer (CRC). Univariate analyses demonstrated that tumor pathology (other/tub1, 2), the proportion of neutrophils and lymphocytes, serum level of C-reactive protein and albumin, neutrophil to lymphocyte ratio, and intraoperative bleeding volume were associated with overall survival. Multivariate analysis using these seven selected features disclosed that only tumor pathology was associated with the overall survival (p<0.001). In addition, tumor pathology was able to divide not only the patients as a whole (p<0.001), but also both patients with stage IVa (p=0.007) and IVb (p=0.007), into two groups for overall survival, respectively. Tumor pathology is not only associated with the overall survival but is also able to divide both patients as a whole and those sub-classified by stage, into two independent groups before surgery.