Annals of surgery
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Review Meta Analysis
Impact of epidural analgesia on mortality and morbidity after surgery: systematic review and meta-analysis of randomized controlled trials.
To quantify benefit and harm of epidural analgesia, compared with systemic opioid analgesia, in adults having surgery under general anesthesia. ⋯ In adults having surgery under general anesthesia, concomitant epidural analgesia reduces postoperative mortality and improves a multitude of cardiovascular, respiratory, and gastrointestinal morbidity endpoints compared with patients receiving systemic analgesia. Because adverse effects and technical failures cannot be ruled out, individual risk-benefit analyses and professional care are recommended.
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Review Meta Analysis
Safety of short, in-hospital delays before surgery for acute appendicitis: multicentre cohort study, systematic review, and meta-analysis.
To determine safety of short in-hospital delays before appendicectomy. ⋯ Short delays of less than 24 hours before appendicectomy were not associated with increased rates of complex pathology in selected patients. These organizational delays may aid service provision, but planned delay beyond this should be avoided. However, where optimal surgical systems allow for expeditious surgery, prompt appendicectomy will still aid fastest resolution of pain for the individual patient.
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Review Meta Analysis
Chronic subdural hematoma management: a systematic review and meta-analysis of 34,829 patients.
To compare the efficacy and safety of multiple treatment modalities for the management of chronic subdural hematoma (CSDH) patients. ⋯ Percutaneous bedside twist-drill drainage is a relatively safe and effective first-line management option. These findings may result in potential health cost savings and eliminate perioperative risks related to general anesthetic.
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Review Meta Analysis
Systematic review and meta-analysis of the role of routine colonic evaluation after radiologically confirmed acute diverticulitis.
To determine the yield of colorectal cancer at routine colonic evaluation after radiologically proven acute diverticulitis. ⋯ The risk of malignancy after a radiologically proven episode of acute uncomplicated diverticulitis is low. In the absence of other indications, routine colonoscopy may not be necessary. Patients with complicated diverticulitis still have a significant risk of colorectal cancer at subsequent colonic evaluation.
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Meta Analysis Comparative Study
Comparison of treatment effect estimates from prospective nonrandomized studies with propensity score analysis and randomized controlled trials of surgical procedures.
We aimed to compare treatment effect estimates from NRSs with PS analysis and RCTs of surgery. ⋯ There was no statistically significant difference in treatment effect between NRSs with PS analysis and RCTs. Prospective NRSs with suitable and careful PS analysis can be relied upon as evidence when RCTs are not possible.