ObjectiveTo compare the short-term outcomes between Ivor Lewis esophagectomy and McKeown esophagectomy under thoracoscopy and laparoscopy for thoracic middle-lower esophageal carcinoma and to investigate the optimal approach.MethodsThe relevant literatures (from database foundation to March 2016) comparing minimally invasive Ivor Lewis esophagectomy and minimally invasive McKeown esophagectomy were searched through PubMed, EMbase, The Cochrane Library, CBM, CNKI, Wanfang Data and VIP. RevMan 5.3 software was used for data analysis.ResultsA total of 870 patients in 5 studies were reviewed and data were pooled for analysis. The score of Newcastle Ottawa for the literatures was 7-8 points. The results showed that compared with the McKeown group, Ivor Lewis group had shorter operation time (WMD=–34.67, 95% CI –53.70 to –15.65, P=0.000 4), less recurrent laryngeal nerve injuries (OR=0.23, 95% CI 0.12 to 0.44, P<0.000 01), anastomotic leakage (OR=0.24, 95% CI 0.14 to 0.41, P<0.000 01), anastomotic stenosis (OR=0.30, 95% CI 0.16 to 0.55, P=0.000 01), and pulmonary complications ( OR=0.25, 95% CI 0.15 to 0.43, P<0.000 01). There was no significant difference between the two groups in intraoperative blood loss, postoperative stay, hospitalization cost and chylothorax incidence. The McKeown group was associated with much more lymph nodes dissection (WMD=–1.16, 95% CI –2.00 to –0.31,P=0.007) than the Ivor Lewis group.ConclusionCompared with McKeown esophagectomy combined with thoracoscopy and laparoscopy, Ivor Lewis esophagectomy combined with thoracoscopy and laparoscopy has some advantages for thoracic middle-lower esophageal carcinoma, but a greater number of lymph nodes are dissected in McKeown procedure.
ObjectiveTo investigate the current status of systematic reviews/meta-analyses (SRs/MAs) registered in PROSPERO by Chinese authors, in order to provide references for improving the registration rate and quality, and finally improve the quality of SRs/MAs. MethodsWe searched PROSPERO (http://www.crd.york.ac.uk/crdweb/) from inception to December 31, 2014, to identify SRs/MAs registered by Chinese authors. Two reviewers independently screened records and extracted data. Excel 2013 was used for data input and management, and Stata 12.0 software was used for statistical analysis (Stata Corp., College Station, TX, USA). ResultsA total of 322 SRs/MAs were included. There was an increasing trend in registration number by year, and 60.6% was registered in 2014. The type of SRs/MAs was mainly the interventional (n=247, 76.7%). These SRs/MAs were related to 21 systematic diseases, and cancer ranked the top one (65, 20.2%). The authors distributed in 26 provinces, and majority of authors' institutes were "Evidence-Based Medicine Center". More than half (56.2%) of SRs/MAs were supported by fundings, but only 39.8% of SRs/MAs were performed cooperatively by two or more institutes. ConclusionThere is a rapid increase in numbers of SRs/MAs registered in PROSPERO by Chinese authors, but the absolute number is still small. The problems include the weakness of cooperative consciousness and lake of awareness in registering SRs/MAs.
It is a challenge for clinicians and diagnostic systematic reviewers to determine the best test in clinical diagnosis and screening. Meanwhile, it also becomes the new chance and challenge for diagnostic test meta-analysis. Network meta-analysis has been commonly used in intervention systematic reviews, which can compare the effect size of all available interventions and to choose the best intervention. Network meta-analysis of diagnostic test can be defined as comparing all available diagnostic technologies in the same conditions based on the common reference tests. In order to provide the guide for diagnostic systematic reviewers, we aims to introduce four methods of conducting diagnostic test accuracy network meta-analysis, and to explore two ranking methods of network meta-analysis of diagnostic test accuracy.