Objective To assess the effectiveness and safety of hand-suture vs. stapling anastomosis in esophagogastrostomy. Methods The following databases such as CBM (1978 to February 2012), VIP (1989 to February 2012), CNKI (1994 to February 2012), WanFang Data (1980 to February 2012), The Cochrane Library, PubMed (1966 to February 2012), EMbase (1974 to February 2012), and relevant webs of clinical trials were searched to collect the randomized controlled trials (RCTs) and quasi-RCTs about hand-suture vs. stapling anastomosis in the incidence of anastomotic leakage following esophagogastrostomy. Moreover, relevant references and grey literature were retrieved on web engines including Google Scholar and Medical Martix, and the Chinese periodicals e.g. Chinese Journal of Oncology were also handsearched. According to the inclusion and exclusion criteria, the literature, was screened, the data were extracted, and the quality of the included studies was assessed. Then meta-analysis was conducted using RevMan 5.0 software. Results A total of 9 RCTs involving 2 202 patients were included. The result of meta-analysis was as follows: the incidence of anastomotic leakage in the stapling anastomosis group was lower than that in the hand-suture anastomosis group (OR=0.43, 95%CI 0.26 to 0.71, Plt;0.01). Conclusion Stapling anastomosis is superior to hand-suture anastomosis in reducing the incidence of anastomotic leakage following esophagogastrostomy. For the limited quality and quantity of the included studies, this conclusion has to be further proved by more high-quality studies.
ObjectivesTo systematically review clinical values of multi-slice spiral computed tomography angiography (MSCTA) in diagnosis of chest pain triple (CPT).MethodsPubMed, EMbase, The Cochrane Library, Web of Science, CNKI, CBM, VIP and WanFang Data databases were searched to collect diagnostic tests on CPT diagnosed by MSCTA from inception to October 2017. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of the included studies. Meta-analysis was performed by Stata 12.0 software. The pooled weighted Sen, Spe, +LR, -LR, and the DOR were calculated, SROC and AUC were drawn.ResultsA total of 11 diagnostic studies were included. The results of meta-analysis showed that the pooled Sen, Spe, +LR, -LR, DOR and AUC of MSCTA for diagnosing CPT were 0.95 (95%CI 0.91 to 0.98), 0.97 (95%CI 0.94 to 0.98), 31.24 (95%CI 15.63 to 62.43), 0.05 (95%CI 0.02 to 0.10), 659.04 (95%CI 236.73 to 1 834.71) and 0.99 (95%CI 0.98 to 1.00), respectively.ConclusionsMSCTA has high sensibility and specificity for diagnosing CPT. Due to limited quantity and quality of the included studies, more high-quality studies are required to verify the above conclusion.