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3篇 您的检索式:作者名="Parv Sains"
    题名 作者 年代 出处 被引量
1Robotic total meso-rectal excision for rectal cancer: A systematic review following the publication of the ROLARR trial显示文摘AIM To compare outcomes in patients undergoing rectal resection by robotic total meso-rectal excision(RTME) vs laparoscopic total meso-rectal excision(LTME).METHODS Standard medical electronic databases such as Pub-Med, MEDLINE, EMBASE and Scopus were searched to find relevant articles. The data retrieved from all types of included published comparative trials in pati-ents undergoing RTME vs LTME was analysed using the principles of meta-analysis. The operative, post-operative and oncological outcomes were evaluated to assess the effectiveness of both techniques of TME. The summated outcome of continuous variables was expressed as standardized mean difference(SMD) and dichotomous data was presented in odds ratio(OR).RESULTS One RCT(ROLARR trial) and 27 other comparative studies reporting the non-oncological and oncological outcomes following RTME vs LTME were included in this review. In the random effects model analysis using the statistical software Review Manager 5.3, the RTME was associated with longer operation time(SMD, 0.46; 95%CI: 0.25, 0.67; z = 4.33; P = 0.0001), early passage of first flatus(P = 0.002), lower risk of conversion(P = 0.00001) and shorter hospitalization(P = 0.01). The statistical equivalence was seen between RTME and LTME for non-oncological variables like blo-od loss, morbidity, mortality and re-operation risk. The oncological variables such as recurrence(P = 0.96), number of harvested nodes(P = 0.49) and positive circumferential resection margin risk(P = 0.53) were also comparable in both groups. The length of distal resection margins was similar in both groups. CONCLUSION RTME is feasible and oncologically safe but failed to demonstrate any superiority over LTME for many sur-gical outcomes except early passage of flatus, lower risk of conversion and shorter hospitalization.Katie Jones Mohamed G Qassem Parv Sains Mirza K Baig Muhammad S Sajid 2018World Journal of Gastrointestinal Oncology2018,10,11:4
2Specimen retrieval approaches in patients undergoing laparoscopic colorectal resections:a literature-based review of published studies显示文摘Objective:To review the published studies reporting various specimen retrieval incisions being used by colorectal surgeons in patients undergoing laparoscopic colorectal resections(LCR).Methods:Standard medical electronic databases were searched to find relevant articles and a summary conclusion was generated.Results:There were 43 studies reporting various approaches used for the purpose of specimen retrieval in 2388 patients undergoing LCR.The most common approaches were periumbilical midline incision(1260 reported case in the literature),transverse incision(583 reported cases in the literature)in the right-or left iliac fossa,depending on the side of colonic resection,and Pfannensteil incision(293 reported cases in the literature).Periumbilical midline incision was associated with the higher risk of developing incisional hernia(odds ratio 53.72;95%confidence interval 7.48–386.04;Z=3.96;P=0.0001).In terms of surgical site infection(SSI),there was no difference between the three common approaches to specimen retrieval.Transanal and transvaginal approaches were associated with higher risk of SSI.Conclusions:Midline,transverse and Pfannensteil incisions were the most commonly used approaches for specimen retrieval following LCR.Midline incision was associated with higher risk of incisional hernia.Risk of SSI was similar in all three common approaches.The transanal and transvaginal approaches pose a higher risk of SSI.These conclusions are based on the combined outcome of published case series,case reports and comparative studies.Randomized,controlled trials with longer follow-up are required before recommending the routine use of any approach for specimen retrieval in patients undergoing LCR.Muhammad S.Sajid Muhammad I.Bhatti Parv Sains Mirza K.Baig 2014Gastroenterology Report2014,2,4:1
3Systematic review of absorbable vs non-absorbable sutures used for the closure of surgical incisions显示文摘AIM: To report a systematic review of published randomized controlled trials(RCTs) investigating the role of absorbable suture(AS) against non-AS(NAS) used for the closure of surgical incisions.METHODS: RCTs investigating the use of AS vs NAS for the closure of surgical incisions were statistically analysed based upon the principles of meta-analysis and the summated outcomes were represented as OR.RESULTS: The systematic search of medical literature yielded 10 RCTs on 1354 patients. Prevalence of wound infection(OR = 0.97; 95%CI: 0.56, 1.69; Z = 0.11; P = 0.92) and operative morbidity(P = 0.45) was comparable in both groups. Nonetheless, the use of AS lead to lower risk of wound break-down(OR = 0.12; 95%CI: 0.04, 0.39; Z = 3.52; P < 0.0004).CONCLUSION: This meta-analysis of 10 RCTs demonstrates that the use of AS is similar to NAS for skin closure for surgical site infection and other operative morbidities. AS do not increase the risk of skin wound dehiscence,rather lead to a reduced risk of wound dehiscence compared to NAS.Muhammad S Sajid Malcolm R Mc Fall Pauline A Whitehouse Parv S Sains 2014World Journal of Gastrointestinal Surgery2014,6,12:0
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