Does carbon dioxide pneumoperitoneum enhance wound metastases following laparoscopic abdominal tumor surgery? A meta-analysis of 20 randomized control studies

The mechanisms involved in the development of wound metastasis following laparoscopic abdominal tumor surgery remain unclear. The aim of this study was to accurately assess whether the duration of carbon dioxide pneumoperitoneum (CDP) during laparoscopic abdominal tumor surgery enhances wound metastases. We conducted a systematic review of PubMed, Cochrane Library, and Embase through December 2013 to identify animal experiments comparing wound recurrence between laparoscopic and gasless laparoscopic procedures or open procedures. The outcome of interest was the number of animals with a wound tumor. Meta-regression was used to assess whether heterogeneity was explained by study level covariates (animal model, study size, CDP pressure, duration, and evaluated time). Twenty randomized control studies involving 1,229 animals were included. Wound recurrence was not significant in the laparoscopic surgery (LP) vs. gasless laparoscopic surgery (GLP) subgroups [odds ratio (OR), 2.23; 95 % confidence interval (CI), 0.90–5.55; P = 0.08) or the LP vs. laparotomy (LA) subgroups (OR, 0.97; 95 % CI, 0.31–3.00; P = 0.08). Overall postoperative wound recurrence results were not significantly different between the study groups and controls (OR, 1.47; 95 % CI, 0.74–2.92; P = 0.28). A meta-regression analysis showed that the outcome was not correlated with the covariates (animal model: P = 0.82; evaluated time: P = 0.30; pressure of CDP: P = 0.12; duration time: P = 0.80). Current evidence suggests that CDP does not enhance wound metastases following laparoscopic abdominal tumor surgery. Additional large sample, well-designed, randomized, controlled trials are needed to further confirm whether CDP duration in laparoscopic abdominal tumor surgery significantly enhances wound recurrence

Performance Evaluation of a Dense MEMS-Based Seismic Sensor Array Deployed in the Sichuan-Yunnan Border Region for Earthquake Early Warning

With the last decades of development, earthquake early warning (EEW) has proven to be one of the potential means for disaster mitigation. Usually, the density of the EEW network determines the performance of the EEW system. For reducing the cost of sensors and building a dense EEW network, an upgraded low-cost Micro Electro Mechanical System (MEMS)-based sensor named GL-P2B was developed in this research. This device uses a new high-performance CPU board and is built on a custom-tailored Linux 3.6.9 operating system integrating with seismological processing. Approximately 170 GL-P2Bs were installed and tested in the Sichuan-Yunnan border region from January 2017 to December 2018. We evaluated its performance on noise-level, dynamic range (DR), useful resolution (NU), collocated recording comparison, and shake map generation. The results proved that GL-P2B can be classified as a type of Class-B sensor. The records obtained are consistent with the data obtained by the collocated traditional force-balanced accelerometers even for stations with an epicenter distance of more than 150 km, and most of the relative percentage difference of peak ground acceleration (PGA) values is smaller than 10%. In addition, with the current density of the GL-P2B seismic network, near-real-time refined shake maps without using values derived for virtual stations could be directly generated, which will significantly improve the capability for earthquake emergency response. Overall, this MEMS-based sensor can meet the requirements of dense EEW purpose and lower the total investment of the National System for Fast Seismic Intensity Report and Earthquake Early Warning project

Systematic review and meta-analysis of single-incision versus conventional multiport laparoscopic splenectomy

Background: There is no consensus that single-incision laparoscopic surgery splenectomy (SILS-SP) is on a par with conventional multiport laparoscopic surgery splenectomy (CMLS-SP). Aims: The aim of this systematic review and meta-analysis was to assess feasibility and safety of SILS-SP when compared with CMLS-SP. Materials and Methods: Eligible articles were identified by searching several databases including PubMed, EMBASE, CNKI (China) and the Cochrane Library, up until February 2016. Studies were reviewed independently and rated by Newcastle–Ottawa Quality Assessment Scale. Evaluated outcomes were complications, operative time, post-operative hospital stay, blood loss, starting diet, post-operative pain scores, conversion and analgesic requirements. Results: Ten retrospective studies met the eligibility criteria. Overall, there was no significant difference between SILS-SP and CMLS-SP in complications, operative time, post-operative hospital stay, blood loss, starting diet, post-operative pain scores, conversion and analgesic requirements. Conclusions: SILS-SP is feasible and safe in certain patients, with no obvious advantages over CMLS-SP. Therefore, it may be considered an alternative to CMLS-SP. We await high-quality, double-blind RCTs. These should include clear statements on standard scores of post-operative pain and cosmetic results, longer follow-up assessment and cost–benefit analysis

Forest plots of postoperative ALT results in subgroup analysis.

<p>(a: day 1; b: day 3; c: day 7).</p

Association between Duration of Carbon Dioxide Pneumoperitoneum during Laparoscopic Abdominal Surgery and Hepatic Injury: A Meta-Analysis - Figure 3

<p>a. Sensitivity analysis. b. Funnel plot analysis to detect publication bias for ALT results on postoperative day 3; each point represents a separate study for the indicated association. c, Funnel plot analysis to detect publication bias for AST results on postoperative day 3; each point represents a separate study for the indicated association.</p

Flow chart for the systematic search and study selection strategy.

<p>Flow chart for the systematic search and study selection strategy.</p

Forest plots of postoperative TB results in subgroup analysis.

<p>(a: day 1; b: day 3; c: day 7).</p

Forest plots of postoperative AST results in subgroup analysis.

<p>(a: day 1; b: day 3; c: day 7).</p