BACKGROUND Health utility assessments have been developed for various conditions,including chronic liver disease.Health utility scores are required for socio-economic evaluations,which can aid the distribution of nati...BACKGROUND Health utility assessments have been developed for various conditions,including chronic liver disease.Health utility scores are required for socio-economic evaluations,which can aid the distribution of national budgets.However,the standard health utility assessment scores for specific health conditions are largely unknown.AIM To summarize the health utility scores,including the EuroQOL 5-dimensions 5-levels(EQ-5D-5L),EuroQol-visual analogue scale,short from-36(SF-36),RAND-36,and Health Utilities Index(HUI)-Mark2/Mark3 scores,for the normal population and chronic liver disease patients.METHODS A systematic literature search of PubMed and MEDLINE,including the Cochrane Library,was performed.Meta-analysis was performed using the RevMan software.Multiple means and standard deviations were combined using the StatsToDo online web program.RESULTS The EQ-5D-5L and SF-36 can be used for health utility evaluations during antiviral therapy for hepatitis C.HUI-Mark2/Mark3 indicated that the health utility scores of hepatitis B patients are roughly 30% better than those of hepatitis C patients.CONCLUSION The EQ-5D-5L is the most popular questionnaire for health utility assessments.Health assessments that allow free registration would be useful for evaluating health utility in patients with liver disease.展开更多
BACKGROUND Mortality after hepatectomy has decreased,and the quality of various surgical approaches to hepatectomy have been evaluated.Various assessments of quality of life(QOL)after hepatectomy have been developed a...BACKGROUND Mortality after hepatectomy has decreased,and the quality of various surgical approaches to hepatectomy have been evaluated.Various assessments of quality of life(QOL)after hepatectomy have been developed and investigated in different clinical settings.AIM To conduct a systematic review and meta-analysis to examine two clinical topics:Laparoscopic hepatectomy vs open hepatectomy,and preoperative QOL status vs postoperative QOL status.METHODS A systematic literature search was performed using PubMed and MEDLINE,including the Cochrane Library Central.The following inclusion criteria were set for inclusion in this meta-analysis:(1)Studies comparing preoperative QOL and postoperative QOL;and(2)Studies comparing QOL between laparoscopic hepatectomy and open hepatectomy.RESULTS A total of 8 articles were included in this meta-analysis.QOL was better after laparoscopic hepatectomy than after open hepatectomy.CONCLUSION The outcomes of evaluations of QOL after hepatectomy can depend on the type of questionnaire used,the timing of the assessment,and the etiology of the hepatic disease.展开更多
BACKGROUND Minimally invasive hepatectomy techniques have developed rapidly since 2000.Pure laparoscopic liver resection(LLR)has become the primary approach for managing liver tumors and procuring donor organs for liv...BACKGROUND Minimally invasive hepatectomy techniques have developed rapidly since 2000.Pure laparoscopic liver resection(LLR)has become the primary approach for managing liver tumors and procuring donor organs for liver transplantation.Robotic liver resection(RLR)has emerged during the last decade.The technical status of RLR seems to be improving.AIM To conduct a systematic review and meta-analysis comparing the short-term clinical outcomes of LLR and RLR over two 5-year periods.METHODS A systematic literature search was performed using PubMed and Medline,including the Cochrane Library.The following inclusion criteria were set for the meta-analysis:(1)Studies comparing LLR vs RLR;and(2)Studies that described clinical outcomes,such as the operative time,intraoperative bleeding,intraoperative conversion rate,and postoperative complications.RESULTS A total of 25 articles were included in this meta-analysis after 40 articles had been subjected to full-text evaluations.The studies were divided into early(n=14)and recent(n=11)groups.In the recent group,the operative time did not differ significantly between LLR and RLR(P=0.70),whereas in the early group the operative time of LLR was significantly shorter than that of RLR(P<0.001).CONCLUSION The initial disadvantages of RLR,such as its long operation time,have been overcome during the last 5 years.The other clinical outcomes of RLR are comparable to those of LLR.The cost and quality-of-life outcomes of RLR should be evaluated in future studies to promote its routine clinical use.展开更多
BACKGROUND Surgical site infections(SSIs)increase mortality,hospital stays,additional medical treatment,and medical costs.Subcutaneous drains prevent SSIs in gynecological and breast surgeries;however,their clinical i...BACKGROUND Surgical site infections(SSIs)increase mortality,hospital stays,additional medical treatment,and medical costs.Subcutaneous drains prevent SSIs in gynecological and breast surgeries;however,their clinical impact in abdominal surgery remains unclear.AIM To investigate whether subcutaneous drains were beneficial in abdominal surgery using a systematic review and meta-analysis.METHODS The database search used PubMed,MEDLINE,and the Cochrane Library.The following inclusion criteria were set for the systematic review:(1)Randomized controlled trial studies comparing SSIs after abdominal surgery with or without subcutaneous drains;and(2)Studies that described clinical outcomes,such as SSIs,seroma formation,the length of hospital stays,and mortality.RESULTS Eight studies were included in this meta-analysis.The rate of total SSIs was significantly lower in the drained group(54/771,7.0%)than in the control group(89/759,11.7%),particularly in gastrointestinal surgery.Furthermore,the rate of superficial SSIs was slightly lower in the drained group(31/517,6.0%)than in the control group(49/521,9.4%).No significant differences were observed in seroma formation between the groups.Hospital stays were shorter in the drained group than in the control group.CONCLUSION Subcutaneous drains after abdominal surgery prevented SSIs and reduced hospital stays but did not significantly affect seroma formation.The timing of drain removal needs to be reconsidered in future studies.展开更多
基金Supported by Grants-in-Aid from JSPS KAKENHI,No.JP 20K10404(to Mizuguchi T)and No.JP 21K10715(to Ishinuki T)the Hokkaido Hepatitis B Litigation Orange Fund,No.2059198(to Mizuguchi T)and No.2136589(to Harada K)+14 种基金Terumo Life Science Foundation,No.2000666Pfizer Health Research Foundation,No.2000777the Viral Hepatitis Research Foundation of Japan,No.3039838Project Mirai Cancer Research Grants,No.202110251Takahashi Industrial and Economic Research Foundation,No.12-003-106Daiichi Sankyo Company,No.2109540Shionogi and Co.,No.2109493MSD,No.2099412Takeda Pharmaceutical Company,No.2000555Sapporo Doto Hospital,No.2039118Noguchi Hospital,No.2029083Doki-kai Tomakomai Hospital,No.2059203Tsuchida Hospital,No.2000092Shinyu-kai Noguchi Hospital,No.2029083(to Mizuguchi T)the Yasuda Medical Foundation,No.28-1(to Ishinuki T).
文摘BACKGROUND Health utility assessments have been developed for various conditions,including chronic liver disease.Health utility scores are required for socio-economic evaluations,which can aid the distribution of national budgets.However,the standard health utility assessment scores for specific health conditions are largely unknown.AIM To summarize the health utility scores,including the EuroQOL 5-dimensions 5-levels(EQ-5D-5L),EuroQol-visual analogue scale,short from-36(SF-36),RAND-36,and Health Utilities Index(HUI)-Mark2/Mark3 scores,for the normal population and chronic liver disease patients.METHODS A systematic literature search of PubMed and MEDLINE,including the Cochrane Library,was performed.Meta-analysis was performed using the RevMan software.Multiple means and standard deviations were combined using the StatsToDo online web program.RESULTS The EQ-5D-5L and SF-36 can be used for health utility evaluations during antiviral therapy for hepatitis C.HUI-Mark2/Mark3 indicated that the health utility scores of hepatitis B patients are roughly 30% better than those of hepatitis C patients.CONCLUSION The EQ-5D-5L is the most popular questionnaire for health utility assessments.Health assessments that allow free registration would be useful for evaluating health utility in patients with liver disease.
基金Supported by Grant-in-Aid from JSPS KAKENHI,No.JP 20K10404(to Mizuguchi T)the Hokkaido Hepatitis B Litigation Orange Fund,No.2059198+9 种基金Terumo Life Science Foundation,No.2000666Pfizer Health Research Foundation,No.2000777Daiichi Sankyo Company,No.2109540Shionogi and Co.,No.2109493MSD,No.2099412Takeda,No,2000555Sapporo Doto Hospital,No.2039118Noguchi Hospital,No.2029083Doki-kai Tomakomai Hospital,No.2059203and Tsuchida Hospital,No.2069231.
文摘BACKGROUND Mortality after hepatectomy has decreased,and the quality of various surgical approaches to hepatectomy have been evaluated.Various assessments of quality of life(QOL)after hepatectomy have been developed and investigated in different clinical settings.AIM To conduct a systematic review and meta-analysis to examine two clinical topics:Laparoscopic hepatectomy vs open hepatectomy,and preoperative QOL status vs postoperative QOL status.METHODS A systematic literature search was performed using PubMed and MEDLINE,including the Cochrane Library Central.The following inclusion criteria were set for inclusion in this meta-analysis:(1)Studies comparing preoperative QOL and postoperative QOL;and(2)Studies comparing QOL between laparoscopic hepatectomy and open hepatectomy.RESULTS A total of 8 articles were included in this meta-analysis.QOL was better after laparoscopic hepatectomy than after open hepatectomy.CONCLUSION The outcomes of evaluations of QOL after hepatectomy can depend on the type of questionnaire used,the timing of the assessment,and the etiology of the hepatic disease.
基金Supported by Grants-in-Aid from JSPS KAKENHI,No.JP 20K10404(to Mizuguchi T)the Hokkaido Hepatitis B Litigation Orange Fund,No.2059198+10 种基金Terumo Life Science Foundation,No.2000666Pfizer Health Research Foundation,No.2000777the Viral Hepatitis Research Foundation of Japan,No.2000638Daiichi Sankyo Company,No.2109540Shionogi and Co.,No.2109493MSD,No.2099412Takeda,No.2000555Sapporo Doto Hospital,No.2039118Noguchi Hospital,No.2029083Doki-kai Tomakomai Hospital,No.2059203Tsuchida Hospital,No.2069231.
文摘BACKGROUND Minimally invasive hepatectomy techniques have developed rapidly since 2000.Pure laparoscopic liver resection(LLR)has become the primary approach for managing liver tumors and procuring donor organs for liver transplantation.Robotic liver resection(RLR)has emerged during the last decade.The technical status of RLR seems to be improving.AIM To conduct a systematic review and meta-analysis comparing the short-term clinical outcomes of LLR and RLR over two 5-year periods.METHODS A systematic literature search was performed using PubMed and Medline,including the Cochrane Library.The following inclusion criteria were set for the meta-analysis:(1)Studies comparing LLR vs RLR;and(2)Studies that described clinical outcomes,such as the operative time,intraoperative bleeding,intraoperative conversion rate,and postoperative complications.RESULTS A total of 25 articles were included in this meta-analysis after 40 articles had been subjected to full-text evaluations.The studies were divided into early(n=14)and recent(n=11)groups.In the recent group,the operative time did not differ significantly between LLR and RLR(P=0.70),whereas in the early group the operative time of LLR was significantly shorter than that of RLR(P<0.001).CONCLUSION The initial disadvantages of RLR,such as its long operation time,have been overcome during the last 5 years.The other clinical outcomes of RLR are comparable to those of LLR.The cost and quality-of-life outcomes of RLR should be evaluated in future studies to promote its routine clinical use.
基金Supported by Grants-in-Aid from JSPS KAKENHI,No.JP 21K10715 and No.JP 20K10404Northern Advancement Center for Science&Technology,No.T-2-2+9 种基金the Yasuda Medical Foundation,No.31010316the Okawa Foundation for Information and Telecommunications,No.41111042Taiju Life Social Welfare Foundation,No.50811490Japan Keirin Autorace Foundation,No.2023M-378Project Mirai Cancer Research Grants,No.31010269Takahashi Industrial and Economic Research Foundation,No.50411278Sapporo Doto Hospital,No.50311211Noguchi Hospital,No.40310551Doki-kai Tomakomai Hospital,No.40710739Tsuchida Hospital,No.50811478.
文摘BACKGROUND Surgical site infections(SSIs)increase mortality,hospital stays,additional medical treatment,and medical costs.Subcutaneous drains prevent SSIs in gynecological and breast surgeries;however,their clinical impact in abdominal surgery remains unclear.AIM To investigate whether subcutaneous drains were beneficial in abdominal surgery using a systematic review and meta-analysis.METHODS The database search used PubMed,MEDLINE,and the Cochrane Library.The following inclusion criteria were set for the systematic review:(1)Randomized controlled trial studies comparing SSIs after abdominal surgery with or without subcutaneous drains;and(2)Studies that described clinical outcomes,such as SSIs,seroma formation,the length of hospital stays,and mortality.RESULTS Eight studies were included in this meta-analysis.The rate of total SSIs was significantly lower in the drained group(54/771,7.0%)than in the control group(89/759,11.7%),particularly in gastrointestinal surgery.Furthermore,the rate of superficial SSIs was slightly lower in the drained group(31/517,6.0%)than in the control group(49/521,9.4%).No significant differences were observed in seroma formation between the groups.Hospital stays were shorter in the drained group than in the control group.CONCLUSION Subcutaneous drains after abdominal surgery prevented SSIs and reduced hospital stays but did not significantly affect seroma formation.The timing of drain removal needs to be reconsidered in future studies.