Cochrane Db Syst Rev
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Benign liver tumours (haemangioma, focal nodular hyperplasia, and hepatic adenoma) have different prevalence and prognosis. Spontaneous rupture and malignant transformation can complicate hepatic adenoma. Elective surgery is controversial, and indications are represented by uncertain diagnosis, presence of symptoms, and prevention of major complications. ⋯ We were unable to find evidence supporting or refuting elective surgery for patients with benign liver tumours. We need large, long-term randomised clinical trials with adequate methodology to assess the benefits and harms of elective surgery.
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Cochrane Db Syst Rev · Jan 2007
ReviewCholecystectomy versus no cholecystectomy in patients with silent gallstones.
Cholecystectomy is currently advised only for patients with symptomatic gallstones. However, about 4% of patients with asymptomatic gallstones develop symptoms including cholecystitis, obstructive jaundice, pancreatitis, and gallbladder cancer. ⋯ There are no randomised trials comparing cholecystectomy versus no cholecystectomy in patients with silent gallstones. Further evaluation of observational studies, which measure outcomes such as obstructive jaundice, gallstone-associated pancreatitis, and/or gall-bladder cancer for sufficient duration of follow-up is necessary before randomised trials are designed in order to evaluate whether cholecystectomy or no cholecystectomy is better for asymptomatic gallstones.
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Lymphocytic colitis is a cause of chronic diarrhea. Therapy is based mainly on case series and uncontrolled trials, or by extrapolation of data for treating collagenous colitis, a related disorder. This review was performed to identify therapies for lymphocytic colitis that have been proven in randomized controlled trials. ⋯ A single trial studying bismuth subsalicylate as therapy for lymphocytic colitis suggests that it may be beneficial. However, it included only 5 patients and no firm conclusions can be made from such a small trial. Larger trials studying treatments for lymphocytic colitis are warranted.
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Cochrane Db Syst Rev · Jan 2007
Review Meta AnalysisDeworming drugs for treating soil-transmitted intestinal worms in children: effects on growth and school performance.
In areas where intestinal worm infections occur, the World Health Organization recommends treating all school children at regular intervals with deworming drugs to improve growth and school performance. The evidence base for this policy needs to be established for countries to commit resources to implement these programmes. ⋯ Deworming drugs used in targeted community programmes may be effective in relation to weight gain in some circumstances but not in others. No effect on cognition or school performance has been demonstrated.
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Cochrane Db Syst Rev · Jan 2007
Review Meta AnalysisRoutine abdominal drainage for uncomplicated liver resection.
The main reasons for inserting a drain after elective liver resections are (i) prevention of sub-phrenic or sub-hepatic fluid collection; (ii) identification and monitoring of post-operative bleeding; (iii) identification and drainage of any bile leak; and (iv) prevent the accumulation of ascitic fluid in cirrhotics. However, there are reports that drain use increases the complication rates. ⋯ There is no evidence to support routine drain use after uncomplicated liver resections.