M. S. Sajid

A meta-analysis on the clinical effectiveness of transversus abdominis plane block

STUDY OBJECTIVE To study the efficacy of the transversus abdominal plane (TAP) block. DESIGN Meta-analysis. SETTING District general hospital. PATIENTS 86 patients in the TAP block group and 88 in the non-TAP block group. MEASUREMENTS Statistical analyses were performed using Microsoft Excel 2007 for Windows XP. Hedges g statistic was used for the calculation of standardized mean differences (SMD). Binary data (nausea) were summarized as risk ratios (RR). MAIN RESULTS Patients with TAP block required less morphine after 24 hours than those who did not have the block (random effects model: SMD -4.81, 95% CI [-7.45, -2.17], z = -3.57, P < 0.001). There was less time to first request of morphine in the non-TAP block group (random effects model: SMD 4.80, 95% CI [2.16, 7.43], z = 3.57, P < 0.001). Patients in the TAP block group had less pain up to 24 hours postoperatively. No statistical differences were found with respect to nausea. CONCLUSIONS TAP block reduces the need for postoperative opioid use, it increases the time first request for further analgesia, it provides more effective pain relief, and it reduces opioid-associated side effects.

Systematic review and meta-analysis of the use of lightweight versus heavyweight mesh in open inguinal hernia repair

The objective of this study was systematically to analyse published randomized trials comparing lightweight mesh (LWM) with heavyweight mesh (HWM) in open inguinal hernia repair.

Open vs laparoscopic approach for reversal of Hartmann's procedure: a systematic review.

Aim  A meta‐analysis of published literature comparing open vs laparoscopic Hartmann’s reversal.

Systematic review and meta-analysis of published trials comparing the effectiveness of transanal endoscopic microsurgery and radical resection in the management of early rectal cancer

A systematic analysis was conducted of trials comparing the effectiveness of transanal endoscopic microsurgery (TEMS) with radical resection (RR) for T1 and T2 rectal cancer.

Open vs laparoscopic repair of full-thickness rectal prolapse: a re-meta-analysis

Objective  A re‐meta‐analysis of available data within the published literature comparing laparoscopic rectopexy (LR) with open repair (OR).

Systematic review of the use of topical diltiazem compared with glyceryltrinitrate for the nonoperative management of chronic anal fissure

Aim  The study analyzed clinical trials investigating the effectiveness of diltiazem (DTZ) and glyceryltrinitrate (GTN) for the nonsurgical management of chronic anal fissure (CAF).

Internet information on colorectal cancer: commercialization and lack of quality control

Objective  The objective of this study was to evaluate the effectiveness of the internet as a source of information for colorectal cancer (CRC).

The efficacy of diltiazem and glyceryltrinitrate for the medical management of chronic anal fissure: a meta-analysis

ObjectiveThe objective of this review is to systematically analyze the prospective randomized controlled trials on the effectiveness of diltiazem (DTZ) and glyceryltrinitrate (GTN) for the pharmacological management of chronic anal fissure (CAF).Materials and methodsA systematic review of the literature was undertaken. Prospective randomized controlled trials on the effectiveness of DTZ for the management of CAF were selected according to specific criteria and analyzed to generate summative data.ResultsFive studies encompassing 263 patients with CAF were retrieved from the electronic databases. Only two randomized controlled trials on 103 patients qualified for the meta-analysis. There were 53 patients in the DTZ group and 50 patients in the GTN group. Both DTZ and GTN were equally effective for the treatment of CAF (random-effect model risk ratio [RR] 0.29 [90.06–1.33] 95% confidence interval [CI], z = 0.62, p = 0.536). However, there was significant heterogeneity between the trials. GTN was associated with higher side effects rate (fixed-effect model RR 0.45 [0.28–0.73] 95% CI, z = −3.22, p = 0.001) and higher headache rate (fixed-effect model RR 0.33 [0.17–0.64] 95% CI, z = −3.27, p = 0.001) as compared to DTZ. There was no statistically significant recurrence rate of CAF between two pharmacotherapies (fixed-effect model RR 0.66 [0.18–2.41] 95% CI, z = −0.62, p = 0.535).ConclusionBoth DTZ and GTN are equally effective and can be used for the management of CAF. However, GTN is associated with a higher rate of side effects (headache/anal irritation), and it should be replaced by DTZ. The recurrence rate of CAF after the use of both pharmacotherapies is equal.

Botulinum toxin vs glyceryltrinitrate for the medical management of chronic anal fissure: a meta‐analysis

Objective  The objective of this review was to analyse systematically the prospective randomized controlled trials on the effectiveness of botulinum toxin (BTX) and glyceryltrinitrate (GTN) for the pharmacological management of chronic anal fissure (CAF).

Carbon dioxide insufflation vs conventional air insufflation for colonoscopy: a systematic review and meta-analysis of published randomized controlled trials.

Conventional air insufflation (AI) may cause prolonged abdominal bloating, excessive abdominal pain and discomfort during colonoscopy. Carbon dioxide may be an acceptable alternative to avoid these complications. The object of this study was to evaluate systematically the effectiveness of carbon dioxide insufflation (CI) for colonoscopy compared with AI.