Pub Date : 2025-01-01DOI: 10.15537/smj.2025.46.1.20240470
Hüseyin Fahri Martlı, Eda Şahingöz, Emre Şimşek, Ayça Tuba Özcan, Efnan Aşık, Sadettin Er, Erdinç Çetinkaya
Objectives: To evaluate the pathological outcomes of colorectal cancer (CRC) patients who were unsuitable for general anesthesia and underwent regional anesthesia in terms of their suitability for oncological surgery.
Methods: A total of 53 patients who underwent mesocolicormesorectal surgery under regional anesthesia at Ankara Bilkent City Hospital, Ankara, Turkey, between May 2019 and May 2023 were retrospectively examined. The negative margins of the proximal, distal, and circumferential margins of specimens, as well as the number of lymph nodes removed, were analyzed.
Results: All the patients had clear proximal, distal, and circumferential surgical margins. The median number of lymph nodes removed was 23.45 (min-max: 3-97). When patients (n=24) who received neoadjuvant therapy were excluded, an insufficient number (<12) of lymph nodes were removed in 3 (7.69%) patients. A total of 3 patients died postsurgery, resulting in a 30-day mortality rate of 5.6%.
Conclusion: For elderly and comorbid individuals with CRC, regional anesthesia can be used to carry out surgery with oncological principles.
{"title":"Oncological surgical outcomes for colorectal cancer surgery with loco-regional anesthesia: A feasibility study.","authors":"Hüseyin Fahri Martlı, Eda Şahingöz, Emre Şimşek, Ayça Tuba Özcan, Efnan Aşık, Sadettin Er, Erdinç Çetinkaya","doi":"10.15537/smj.2025.46.1.20240470","DOIUrl":"10.15537/smj.2025.46.1.20240470","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the pathological outcomes of colorectal cancer (CRC) patients who were unsuitable for general anesthesia and underwent regional anesthesia in terms of their suitability for oncological surgery.</p><p><strong>Methods: </strong>A total of 53 patients who underwent mesocolicormesorectal surgery under regional anesthesia at Ankara Bilkent City Hospital, Ankara, Turkey, between May 2019 and May 2023 were retrospectively examined. The negative margins of the proximal, distal, and circumferential margins of specimens, as well as the number of lymph nodes removed, were analyzed.</p><p><strong>Results: </strong>All the patients had clear proximal, distal, and circumferential surgical margins. The median number of lymph nodes removed was 23.45 (min-max: 3-97). When patients (n=24) who received neoadjuvant therapy were excluded, an insufficient number (<12) of lymph nodes were removed in 3 (7.69%) patients. A total of 3 patients died postsurgery, resulting in a 30-day mortality rate of 5.6%.</p><p><strong>Conclusion: </strong>For elderly and comorbid individuals with CRC, regional anesthesia can be used to carry out surgery with oncological principles.</p>","PeriodicalId":21453,"journal":{"name":"Saudi Medical Journal","volume":"46 1","pages":"59-64"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11717096/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142954213","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Does having more chronic conditions increase older adults' risk of declining kidney function?","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":21453,"journal":{"name":"Saudi Medical Journal","volume":"46 1","pages":"110"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11717101/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142954205","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01DOI: 10.15537/smj.2025.46.1.20240679
Ruqayyatu A Imam, Hassan A Elechi, Hauwa Y Musa, Adamu I Rabasa, Habiba B Bakari
Objectives: To determine the prevalence and pattern of hypoglycemia among children admitted to the Emergency Pediatric Unit (EPU) at the University of Maiduguri Teaching Hospital, Maiduguri, Nigeria.
Methods: A cross-sectional study was conducted between February and September 2020. Blood glucose, along with other relevant laboratory investigations, was measured for each patient upon admission to the EPU using a point-of-care test glucometer (ACCU-CHEK with strips).
Results: Of the 340 children recruited for the study, 54 patients had hypoglycemia (<2.2 mmol/L), giving a prevalence rate of 15.9%. Thirty-six (66.7%) of the children with hypoglycemia were under the age of 5 years (odds ratio [OR]: 6.218 [1.077-35.912], p=0.041) and 26 (48.1%) were severely underweight (OR: 3.692 [1.266-10.971], p=0.017). Factors such as not having eaten for at least 16 h, weakness, and coma at presentation all independently predicted hypoglycemia (OR: 5.696 [1.768-18.352], 6.556 [1.730-24.850], 9.479 [3.092-29.059], p=0.004, 0.006 and <0.001) respectively. Severe malaria was also independently related to hypoglycemia (OR: 2.720 [0.554-13.365], p=0.021).
Conclusion: Hypoglycemia is a common occurrence among children admitted to the EPU. Factors such as being under five years old, in a coma, weakness, severe malaria, and prolonged fasting were all identified as independent predictors of hypoglycemia. Therefore, routine blood glucose monitoring of children admitted to the EPU, specifically those at higher risk, is recommended.
{"title":"Predictors of hypocalcemia among children admitted in the Emergency Pediatric Unit of the University of Maiduguri Teaching Hospital, Maiduguri, Nigeria.","authors":"Ruqayyatu A Imam, Hassan A Elechi, Hauwa Y Musa, Adamu I Rabasa, Habiba B Bakari","doi":"10.15537/smj.2025.46.1.20240679","DOIUrl":"10.15537/smj.2025.46.1.20240679","url":null,"abstract":"<p><strong>Objectives: </strong>To determine the prevalence and pattern of hypoglycemia among children admitted to the Emergency Pediatric Unit (EPU) at the University of Maiduguri Teaching Hospital, Maiduguri, Nigeria.</p><p><strong>Methods: </strong>A cross-sectional study was conducted between February and September 2020. Blood glucose, along with other relevant laboratory investigations, was measured for each patient upon admission to the EPU using a point-of-care test glucometer (ACCU-CHEK with strips).</p><p><strong>Results: </strong>Of the 340 children recruited for the study, 54 patients had hypoglycemia (<2.2 mmol/L), giving a prevalence rate of 15.9%. Thirty-six (66.7%) of the children with hypoglycemia were under the age of 5 years (odds ratio [OR]: 6.218 [1.077-35.912], <i>p</i>=0.041) and 26 (48.1%) were severely underweight (OR: 3.692 [1.266-10.971], <i>p</i>=0.017). Factors such as not having eaten for at least 16 h, weakness, and coma at presentation all independently predicted hypoglycemia (OR: 5.696 [1.768-18.352], 6.556 [1.730-24.850], 9.479 [3.092-29.059], <i>p</i>=0.004, 0.006 and <0.001) respectively. Severe malaria was also independently related to hypoglycemia (OR: 2.720 [0.554-13.365], <i>p</i>=0.021).</p><p><strong>Conclusion: </strong>Hypoglycemia is a common occurrence among children admitted to the EPU. Factors such as being under five years old, in a coma, weakness, severe malaria, and prolonged fasting were all identified as independent predictors of hypoglycemia. Therefore, routine blood glucose monitoring of children admitted to the EPU, specifically those at higher risk, is recommended.</p>","PeriodicalId":21453,"journal":{"name":"Saudi Medical Journal","volume":"46 1","pages":"78-85"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11717099/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142954216","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01DOI: 10.15537/smj.2025.46.1.20240826
Abdullah Ayed, Raed I Alwadai, Assad A Rezigalla
The horseshoe kidney (HSK) is a common renal abnormality mostly asymptomatic. This may be linked to chromosomal and organ anomalies. A 27-year-old male patient presented with mild recurrent lower abdominal pain associated with dysuria. No history of renal disease. Laboratory investigations revealed red blood cells (RBC), white blood cells (WBC), and bacterial growth in the urine. A CT urogram showed an HSK with a unilateral left-sided ureter. The patient was diagnosed with a urinary tract infection (UTI) and managed with regular follow-up. This report describes a rare case of an HSK with a unilateral left-sided, typically implanted ureter and highlights the radiological findings and management. Asymptomatic HSKs may present with or without associated anomalies. UTI is a common asymptomatic presentation. An HSK with a unilateral left-sided normally implanted ureter is rare. The present case of HSK was associated with recurrent UTI, which was managed accordingly.
{"title":"A rare case of a horseshoe kidney with a single left-sided ureter presented with recurrent urinary tract infection.","authors":"Abdullah Ayed, Raed I Alwadai, Assad A Rezigalla","doi":"10.15537/smj.2025.46.1.20240826","DOIUrl":"10.15537/smj.2025.46.1.20240826","url":null,"abstract":"<p><p>The horseshoe kidney (HSK) is a common renal abnormality mostly asymptomatic. This may be linked to chromosomal and organ anomalies. A 27-year-old male patient presented with mild recurrent lower abdominal pain associated with dysuria. No history of renal disease. Laboratory investigations revealed red blood cells (RBC), white blood cells (WBC), and bacterial growth in the urine. A CT urogram showed an HSK with a unilateral left-sided ureter. The patient was diagnosed with a urinary tract infection (UTI) and managed with regular follow-up. This report describes a rare case of an HSK with a unilateral left-sided, typically implanted ureter and highlights the radiological findings and management. Asymptomatic HSKs may present with or without associated anomalies. UTI is a common asymptomatic presentation. An HSK with a unilateral left-sided normally implanted ureter is rare. The present case of HSK was associated with recurrent UTI, which was managed accordingly.</p>","PeriodicalId":21453,"journal":{"name":"Saudi Medical Journal","volume":"46 1","pages":"102-106"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11717107/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142954168","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"WHO announces first prequalification of a tuberculosis diagnostic test.","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":21453,"journal":{"name":"Saudi Medical Journal","volume":"46 1","pages":"113"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11717102/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142953161","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01DOI: 10.15537/smj.2025.46.1.20240341
Ying Gao, Jinmiao Wang, Shoujun Wang, Weijie Tao, Ran Duan, Jie Hao, Ming Gao
Objectives: To construct and verify a nomogram for post-neoadjuvant chemotherapy survival predication in elderly women with triple-negative invasive ductal breast cancer.
Methods: Elderly patients diagnosed as triple-negative invasive ductal breast cancer between 2019-2000 were screened from surveillance, epidemiology, and end results database. Depending on the post-neoadjuvant chemotherapy pathological response, they were assigned to the complete or non-complete response group. Inter-group clinicopathological characteristics and disease-specific and overall survivals were compared. Then, they were allocated randomly into the training or validation cohort. A prediction nomogram was developed in the training cohort and verified in the validation cohort.
Results: A total of 382 patients were included, with 285 patients in non-response group and 97 patients in response group. After propensity score matching, disease-specific survival showed a significant difference between response and non-response groups (88.7% versus 64.6%, p<0.001). The training cohort included 196 patients and the validation cohort included 82 patients. A total of 7 variables (age, race, tumor location, tumor-node-metastasis stage, summary stage, receipt of surgery, and response to neoadjuvant chemotherapy) were integrated to construct a survival prediction nomogram. The C-indexes were 0.756 in the training cohort and 0.791 in the validation cohort. In both cohorts, the predicted survival showed satisfactory coherence with the actual survival in the calibration curve analysis.
Conclusion: In elderly women with triple-negative invasive ductal breast cancer, post-neoadjuvant chemotherapy pathological complete response could indicate improved disease-specific survival. A novel survival prediction nomogram was created to have satisfactory performance in these patients.
{"title":"Development and validation of a nomogram to predict survival after neoadjuvant chemotherapy in elderly women with triple-negative invasive ductal breast cancer: A SEER population-based study.","authors":"Ying Gao, Jinmiao Wang, Shoujun Wang, Weijie Tao, Ran Duan, Jie Hao, Ming Gao","doi":"10.15537/smj.2025.46.1.20240341","DOIUrl":"10.15537/smj.2025.46.1.20240341","url":null,"abstract":"<p><strong>Objectives: </strong>To construct and verify a nomogram for post-neoadjuvant chemotherapy survival predication in elderly women with triple-negative invasive ductal breast cancer.</p><p><strong>Methods: </strong>Elderly patients diagnosed as triple-negative invasive ductal breast cancer between 2019-2000 were screened from surveillance, epidemiology, and end results database. Depending on the post-neoadjuvant chemotherapy pathological response, they were assigned to the complete or non-complete response group. Inter-group clinicopathological characteristics and disease-specific and overall survivals were compared. Then, they were allocated randomly into the training or validation cohort. A prediction nomogram was developed in the training cohort and verified in the validation cohort.</p><p><strong>Results: </strong>A total of 382 patients were included, with 285 patients in non-response group and 97 patients in response group. After propensity score matching, disease-specific survival showed a significant difference between response and non-response groups (88.7% versus 64.6%, <i>p</i><0.001). The training cohort included 196 patients and the validation cohort included 82 patients. A total of 7 variables (age, race, tumor location, tumor-node-metastasis stage, summary stage, receipt of surgery, and response to neoadjuvant chemotherapy) were integrated to construct a survival prediction nomogram. The C-indexes were 0.756 in the training cohort and 0.791 in the validation cohort. In both cohorts, the predicted survival showed satisfactory coherence with the actual survival in the calibration curve analysis.</p><p><strong>Conclusion: </strong>In elderly women with triple-negative invasive ductal breast cancer, post-neoadjuvant chemotherapy pathological complete response could indicate improved disease-specific survival. A novel survival prediction nomogram was created to have satisfactory performance in these patients.</p>","PeriodicalId":21453,"journal":{"name":"Saudi Medical Journal","volume":"46 1","pages":"43-51"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11717112/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142954204","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"In this issue.","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":21453,"journal":{"name":"Saudi Medical Journal","volume":"46 1","pages":"1"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11717105/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142954211","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01DOI: 10.15537/smj.2025.46.1.20240537
Ahlam A ALJohani, Jehan M Alhazmi, Osama H Alsaedi, Ahmed F Al-Ahmadi, Noura S Alshammary
Objectives: To evaluate the impact of UCCs on reducing non-urgent Emergency Department (ED) visits and improving patient flow, focusing on metrics such as door-to-doctor time, doctor-to-decision time, and overall patient disposition.
Methods: This observational cohort pre-post study analyzed data from 198,050 ED visits to King Fahad Hospital, Al Madina Al Munawara between June 2021 and May 2023 and compared visit patterns before and after UCC implementation.
Results: Post-UCC implementation, the average door-to-doctor time decreased but was not statistically significant. Significant reductions were observed in doctor-to-decision and door-to-disposition times for CTAS 3 patients. However, overall patient flow improvements were not fully realized, highlighting the need for enhanced public awareness and integration of UCCs with EDs.
Conclusion: The study shows that while urgent care centers in Al Madina Al Munawara have improved efficiency for some patient categories, they don't fully achieve expected reductions in waiting times and patient flow. Seasonal variations, limited patient awareness, and data constraints affect outcomes.
{"title":"Impact of urgent care centers on emergency department visits in Al Madina Al Munawara: A pre-post study.","authors":"Ahlam A ALJohani, Jehan M Alhazmi, Osama H Alsaedi, Ahmed F Al-Ahmadi, Noura S Alshammary","doi":"10.15537/smj.2025.46.1.20240537","DOIUrl":"10.15537/smj.2025.46.1.20240537","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the impact of UCCs on reducing non-urgent Emergency Department (ED) visits and improving patient flow, focusing on metrics such as door-to-doctor time, doctor-to-decision time, and overall patient disposition.</p><p><strong>Methods: </strong>This observational cohort pre-post study analyzed data from 198,050 ED visits to King Fahad Hospital, Al Madina Al Munawara between June 2021 and May 2023 and compared visit patterns before and after UCC implementation.</p><p><strong>Results: </strong>Post-UCC implementation, the average door-to-doctor time decreased but was not statistically significant. Significant reductions were observed in doctor-to-decision and door-to-disposition times for CTAS 3 patients. However, overall patient flow improvements were not fully realized, highlighting the need for enhanced public awareness and integration of UCCs with EDs.</p><p><strong>Conclusion: </strong>The study shows that while urgent care centers in Al Madina Al Munawara have improved efficiency for some patient categories, they don't fully achieve expected reductions in waiting times and patient flow. Seasonal variations, limited patient awareness, and data constraints affect outcomes.</p>","PeriodicalId":21453,"journal":{"name":"Saudi Medical Journal","volume":"46 1","pages":"65-70"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11717114/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142954210","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Milestone: COVID-19 five years ago.","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":21453,"journal":{"name":"Saudi Medical Journal","volume":"46 1","pages":"111-112"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11717104/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142954212","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objectives: To assess the effectiveness of reinforcing sutures after surgery for rectal cancer and its associated impact on postoperative recovery. Anastomotic leakage (AL) is a common and serious complication after anteriorrectal resection. It is currently unclear whether laparoscopic intracorporeal reinforcingsutures can effectively reduce the incidence of AL.
Method: From inception to 2024, the literature search was conducted using a variety of databases, including PubMed, the Chinese biomedical literature database (CBM), Wanfang, EMBASE, the Cochrane Library, VIP, and China National Knowledge Infrastructure (CNKI), to identify relevant articles. Free-text forms were used to search the literature: "rectal cancer", "rectal neoplasms", "reinforcing sutures", and "anastomotic leakage" or AL. The search was undertaken by 2 different reviewers, who independently evaluated the studies.
Result: Twelve retrospective studies and 4 RCTs were analyzed in all. A total of 3147 individuals were identified, with 1512 receiving reinforcing sutures and 1635 not. Patients who underwent laparoscopic surgery to get reinforcing sutures had a notably decreased occurrence of anastomotic leakage, according to our data. (OR 0.33; 95% CI 0.21-0.51, p<0.00001). It had an earlier anal exhaust time and a shorter hospitalization. The 2 different groups did not differ substantially with regard to intraoperative blood loss or the rate of postoperative intestinal obstruction. However, patients who received reinforced sutures via a laparoscopic approach cost more operative time (MD=16.77, 95% CI 11.31-22.23, p<0.00001).
Conclusion: The occurrence of AL can be greatly decreased through the use of a laparoscopic approach for anastomotic reinforcement, which may be a better option after radical surgery for rectal patients. However, more RCT studies with large sample sizes are needed.PROSPERO: CRD42024548847.
{"title":"Effect of laparoscopic intracorporeal reinforcing sutures to prevent anastomotic leakage: A meta-analysis.","authors":"Feng-Bing Wang, Min-Min Song, Nian-Wen Zhang, Wei-Feng, Bin-Liu, Peng-Fei Zhang","doi":"10.15537/smj.2025.46.1.20240422","DOIUrl":"10.15537/smj.2025.46.1.20240422","url":null,"abstract":"<p><strong>Objectives: </strong>To assess the effectiveness of reinforcing sutures after surgery for rectal cancer and its associated impact on postoperative recovery. Anastomotic leakage (AL) is a common and serious complication after anteriorrectal resection. It is currently unclear whether laparoscopic intracorporeal reinforcingsutures can effectively reduce the incidence of AL.</p><p><strong>Method: </strong>From inception to 2024, the literature search was conducted using a variety of databases, including PubMed, the Chinese biomedical literature database (CBM), Wanfang, EMBASE, the Cochrane Library, VIP, and China National Knowledge Infrastructure (CNKI), to identify relevant articles. Free-text forms were used to search the literature: \"rectal cancer\", \"rectal neoplasms\", \"reinforcing sutures\", and \"anastomotic leakage\" or AL. The search was undertaken by 2 different reviewers, who independently evaluated the studies.</p><p><strong>Result: </strong>Twelve retrospective studies and 4 RCTs were analyzed in all. A total of 3147 individuals were identified, with 1512 receiving reinforcing sutures and 1635 not. Patients who underwent laparoscopic surgery to get reinforcing sutures had a notably decreased occurrence of anastomotic leakage, according to our data. (OR 0.33; 95% CI 0.21-0.51, <i>p</i><0.00001). It had an earlier anal exhaust time and a shorter hospitalization. The 2 different groups did not differ substantially with regard to intraoperative blood loss or the rate of postoperative intestinal obstruction. However, patients who received reinforced sutures via a laparoscopic approach cost more operative time (MD=16.77, 95% CI 11.31-22.23, <i>p</i><0.00001).</p><p><strong>Conclusion: </strong>The occurrence of AL can be greatly decreased through the use of a laparoscopic approach for anastomotic reinforcement, which may be a better option after radical surgery for rectal patients. However, more RCT studies with large sample sizes are needed.<b>PROSPERO:</b> CRD42024548847.</p>","PeriodicalId":21453,"journal":{"name":"Saudi Medical Journal","volume":"46 1","pages":"9-18"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11717097/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142954206","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}