Medium and long-term complications difference between laparoscopic transcystic common bile duct exploration versus endoscopic sphincterotomy against choledocholithiasis: A protocol for systematic review and meta-analysis.

BACKGROUND: Common bile duct stone (CBDS) is typically manifested with abdominal pain, chills, fever, and jaundice. Laparoscopic transcystic common bile duct exploration (LTCBDE) and endoscopic sphincterotomy (EST) are currently the main minimally invasive methods for the treatment of CBDS. However, there are few studies about the differences of medium and long-term complication after EST or LTCBDE. Therefore, we will conduct a meta-analysis and systematic review to systematically evaluate the difference of medium and long-term complications between EST and LTCBDE against CBDS. METHODS: Randomized controlled trials of EST or LTCBDE against CBDS will be searched in several English and Chinese databases with the following vocabularies: "laparoscopic transcystic common bile duct exploration," "endoscopic sphincterotomy," "choledocholithiasis," "common bile duct stone" until December, 2020. Two reviewers will independently conduct the literature extraction, risk of bias assessment, and statistical analysis. RESULTS AND CONCLUSIONS: The study will help to systematically evaluate the difference of medium and long-term complication between EST and LTCBDE against CBDS. OSF REGISTRATION NUMBER: DOI 10.17605/OSF.IO/5U7SA.

Short-term efficacy of precise hepatectomy and traditional hepatectomy for primary liver cancer: a systematic review and meta-analysis.

BACKGROUND: As the base of hepatitis B patients has been increasing annually, it has developed into a high incidence source of primary liver cancer worldwide. The fatality rate of liver cancer is still relatively high. Among the many treatment methods, liver resection is the first-line treatment of primary liver cancer. Although precision hepatectomy has achieved rapid development in recent years, the understanding of its efficacy is still not completely clear. This study aimed to analyze and compare the safety and effectiveness of precision hepatectomy and traditional hepatectomy in the treatment of primary liver cancer. METHODS: We performed a literature search of the CNKI, Wanfang, Weipu.com, PubMed, Cochrane Library, Web of Science databases for studies on precision liver resection (precision group) and traditional liver resection (traditional group) for the treatment of primary liver cancer. Data including the operation time, intraoperative blood loss, hospital stay, postoperative complications, liver function, and survival rate were analyzed using RevMan 5.3 software to compare the differences in the effects of the two surgical procedures. RESULTS: Ten articles were included in the study, involving a total of 1,969 patients, including 1,045 cases in the precision group and 924 cases in the traditional group. Meta-analysis results showed that compared with the traditional group, the precision group had a longer operation time [mean difference (MD) =8.01, P=0.004], and total bilirubin (TBiL; MD =-2.78, P=0.055) was similar. Meanwhile, the precision group exhibited advantages in terms of intraoperative blood loss (MD =-149.37, P=0.000), hospital stay (MD =-5.59, P=0.000), postoperative liver function indexes [aspartate aminotransferase (AST; MD =-11.61, P=0.000) and alanine aminotransferase (ALT; MD =-18.53, P=0.000)], postoperative complication rate [relative risk (RR) =0.51, P=0.000], and 1-year survival rate (RR =1.11, P=0.000). DISCUSSION: The application of precision surgery in the treatment of primary liver cancer can be a safe and effective method. It can minimize intraoperative blood loss, mitigate surgical risk, reduce postoperative complications, improve patient prognosis and quality of life, and provide better short-term curative effect and patient benefits.

Analysis of the expression of plasma omentin-1 level in colorectal cancer and its correlation with prognosis.

BACKGROUND: Colorectal cancer (CRC) is a malignant tumor of the digestive tract, with high incidence and mortality. This study aims to investigate the expression of plasma omentin-1 level in patients with CRC and its correlation with the prognosis of patients. METHODS: Clinical data of 319 patients (case group) who underwent radical resection of CRC in our hospital from June 2015 to March 2018 were collected, simultaneously, 300 people without the apparent physical disease who underwent physical examination in our hospital during the same period were randomly selected as the control group, plasma omentin-1 levels in the two groups were compared by T-test. Cancer patients were followed up, and multi-factor COX regression analysis was used to analyze the factors affecting patients' recurrence and survival. RESULTS: The level of plasma omentin-1 in patients with colorectal cancer is closely related to TNM staging and lymph node metastasis. The CRC case group was significantly reduced after surgery, but it was still higher than that in the control group (P<0.05). At the end of the follow-up, 28 cases were lost to follow-up, and 291 cases (91.22%) were effectively followed up. During the follow-up period, the recurrence and metastasis rate was 30.58% (89/291), and the mortality rate was 19.26% (56/291). According to the multi-factor analysis, the risk factors for the recurrence of CRC patients were TNM stage III-IV (OR =1.978, 95% CI: 1.088-3.596), lymph node metastasis (OR =2.073, 95% CI: 1.179-3.645) and omentin-1 level ≥50 ng/mL (OR =3.347, 95% CI: 1.416-7.912). The risk factors for the survival of patients with CRC were poorly differentiated (OR =1.960, 95% CI: 0.985-3.900), lymph node metastasis (OR =2.452, 95% CI: 1.213-4.956), vascular carcinoma thrombus (OR =2.026, 95% CI: 1.036-3.960) and omentin-1 level ≥50 ng/mL (OR =2.067, 95% CI: 1.013-4.218). CONCLUSIONS: The level of plasma omentin-1 is highly expressed in patients with CRC, an independent risk factor for the recurrence and survival of patients.