Annals of surgery
-
Review Meta Analysis
Immunoenhancing enteral and parenteral nutrition for gastrointestinal surgery: a multiple-treatments meta-analysis.
Frequentist meta-analyses have demonstrated that immunoenhancing parenteral nutrition (IMPN) and enteral nutrition (IMEN) reduce the incidence of infection and shorten the length of hospital stays compared with standard parenteral nutrition (SPN) and enteral nutrition (SEN). The aim of this study was to evaluate which kind of nutrition-SPN, SEN, IMPN, and IMEN-is most efficacious for reducing the incidence of complications after gastrointestinal surgery. ⋯ This study suggests that IMEN outperformed other nutrition types for reducing complications and IMEN should be considered the best available option.
-
Review Comparative Study
Abdominoperineal resection provides better local control but equivalent overall survival to local excision of anorectal malignant melanoma: a systematic review.
To determine whether the extent of surgery is associated with survival in anorectal malignant melanoma (ARMM). ⋯ Although several limitations, such as inclusion of only retrospective studies with relatively small sample size and selection biases for surgical procedure, are involved, this meta-analysis suggested that APR has no survival benefit; however, APR confers better local control than LE. Given that local failures after LE could be managed by salvage surgery, minimizing morbidity and maximizing quality of life should be the focus in surgical treatment of ARMM.
-
To develop predictive models for early triage of burn patients based on hypersusceptibility to repeated infections. ⋯ Early triage of burn patients more susceptible to infections can be made using clinical characteristics and/or genomic signatures. Genomic signature suggests new insights into the pathophysiology of hypersusceptibility to infection may lead to novel potential therapeutic or prophylactic targets.
-
Observational Study
Association between gene expression biomarkers of immunosuppression and blood transfusion in severely injured polytrauma patients.
To explore the hypothesis that blood transfusion contributes to an immunosuppressed phenotype in severely injured patients. ⋯ The primarily immunosuppressive inflammatory response to polytrauma may be exacerbated by the transfusion of blood products. Furthermore, transfusion was associated with an increased susceptibility to nosocomial infections.
-
Meta-analyses are useful tools for summarizing surgical evidence as they aim to encompass multiple sources of information on a particular research question, but they may be prone to methodological and reporting biases. We evaluated the conduct and reporting of meta-analyses of surgical interventions. ⋯ Substantial gaps in the conduct and reporting of meta-analyses within the surgical literature exist, mainly in the specification of aims and/or objectives, the use of preplanned protocols, and the evaluation of potential bias at the review (rather than trial) level. Editorial insistence on using reporting guidelines would improve this situation.