The Journal of surgical research
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No treatment is available to reverse injury associated with traumatic brain injury (TBI). Progenitor cell therapies show promise in both preclinical and clinical studies. We conducted a meta-analysis of preclinical studies using progenitor cells to treat TBI. ⋯ Our meta-analysis study reveals an overall positive effect of progenitor cell therapies on LV and NSS with a trend toward improved motor function and spatial learning in different TBI animal models.
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Severe bleeding related to cardiac surgery is associated with increased morbidity and mortality. Thromboelastography (TEG) and thromboelastometry (ROTEM) are point-of-care tests (POCT). Bedside ROTEM/TEG can rapidly detect changes in blood coagulation and therefore provide a goal-directed, individualized coagulation therapy. In this meta-analysis, we aimed to determine the current evidence for or against POCT-guided algorithm in patients with severe bleeding after cardiac surgery. ⋯ TEG/ROTEM-based coagulation management decreases the risk of allogeneic blood product exposure after cardiac surgery. Furthermore, it results in significantly lower re-exploration rate, decreased incidence of postoperative AKI, and thromboembolic events in cardiac surgery patients. Results of this meta-analysis indicate that POCT-guided transfusion therapy is superior to the current standard of care.
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Meta Analysis
The effect of early goal-directed therapy on mortality in patients with severe sepsis and septic shock: a meta-analysis.
The Surviving Sepsis Campaign has recommended early goal-directed therapy (EGDT) as an essential strategy to decrease mortality among patients with severe sepsis and septic shock. However, three latest multicenter trials failed to show its benefit in the patients with severe sepsis and septic shock. This article was to evaluate the effect of EGDT on the mortality of patients with severe sepsis and septic shock. ⋯ This meta-analysis suggests that EGDT can significantly reduce the mortality among patients with severe sepsis and septic shock.
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Review Meta Analysis
Efficacy of triclosan-coated sutures for reducing risk of surgical site infection in adults: a meta-analysis of randomized clinical trials.
Surgical site infection (SSI) is the third most frequent type of nosocomial infections. Triclosan-coated sutures are often used to reduce the risk of SSI, but studies examining this have given conflicting results. Therefore, this meta-analysis was performed to assess the efficacy of triclosan-coated sutures for reducing risk of SSI in adults. ⋯ Triclosan-coated sutures can decrease the incidence of SSI in abdominal surgeries and might not interfere with wound healing process. Nevertheless, further studies are needed to examine whether triclosan-coated sutures are effective at preventing SSI in non-abdominal surgeries and to further study the interaction of antibiotic prophylaxis with triclosan-coated sutures.
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Robotics, as an innovation of minimally invasive surgical methods, is developing rapidly for colectomy. But there is still no consensus on its comparative merit compared with laparoscopic resections. We conducted this meta-analysis that included randomized controlled trials and nonrandomized controlled trials of robotic colectomy (RC) versus laparoscopic colectomy (LC) to evaluate whether the safety and efficacy of RC are equivalent to those of LC. ⋯ RC can be performed safely and effectively with the number of lymph nodes extracted similar to LC. In addition, it can provide potential advantages of a shorter hospital stay, a shorter time to recovery of bowel function, and lower occurrence of postoperative complications. These findings seem to support the use of robotics for the minimally invasive surgical management of colectomy. However, RC had longer operating time. Future studies involving RC should focus on minimizing duration of operation.