ObjectiveTo systematically review the effect of laparoscopy versus laparotomy for borderline ovarian tumors (BOTs) on postoperative recurrence. MethodsWe searched PubMed, The Cochrane Library (Issue 11, 2015), EMbase, Web of Science, CNKI, WanFang Data and CBM databases from inception to Nov. 2015, to collect relevant clinical studies comparing laparoscopy and laparotomy for BOTs. Two reviewer independently screened literature, extracted data and assessed the risk of bias of include studies by using NOS scale. Then, meta-analysis was performed by using RevMan 5.3 software. ResultsNineteen cohort studies were included. The scores of NOS scale showed that 10 studies were < 7 points, while the other 9 studies were≥7 points. The results of meta-analysis showed that: the recurrence rate of tumor (OR=1.75, 95%CI 1.05 to 2.91, P=0.03) in the laparoscopy group was higher than that in the laparotomy group, but no significant differences were found in further subgroup analysis according to type of operations (conservative surgery: OR=1.22, 95%CI 0.71 to 2.08, P=0.47; non-conservative surgery: OR=4.38, 95% CI 0.85 to 22.68, P=0.08). The diameter of tumor in the laparoscopy group was significant smaller than that in the laparotomy group (MD=-6.88, 95% CI-8.15 to-5.61, P < 0.000 01), and the rate of rupture of tumor in the laparoscopy group was significant higher than that in the laparotomy group (OR=3.99, 95% CI 2.54 to 6.26, P < 0.000 01). ConclusionCurrent evidence shows, compared with laparotomy, laparoscopy has similar effect on postoperative recurrence and smaller diameter of tumor, but laparoscopy could increase the rate of rupture of tumor. Due to the limited quality and sample size of included studies, more high quality and large sample size studies are need to prove the above conclusion.
ObjectiveTo evaluate the efficacy and safety of moistened versus dry misoprostol for mid-trimester pregnancy termination. MethodsDatabases including PubMed, EMbase, The Cochrane Library (Issue 11, 2015), Web of Science, WanFang Data, CBM and CNKI were searched to collect randomized controlled trials (RCTs) about misoprostol for mid-trimester pregnancy termination from inception to Nov. 2015. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of included studies. Then, meta-analysis was performed using RevMan 5.3 software. ResultsFive RCTs involving 742 patients were included. The results of meta-analysis showed that, compared with dry tablet, moistened tablet could reduce induction-abortion interval (MD=-0.41, 95% CI-0.75 to-0.08, P=0.02), while there were no significant differences between two groups in completely abortion within 24 hours or 48 hours, nausea, vomiting, chill, fever, diarrhea, retained placenta, blood loss and total dose of misoprostol. ConclusionCurrent evidence shows that, compared with the dry misoprostol, the moistened misoprostol for treating mid-trimester pregnancy termination could reduce the induction-abortion interval without increasing adverse reactions. Due to the limited quality of quantity of included studies, more high-quality and large-scale RCTs are needed to prove the above conclusion.