ABSTRACT
Aim of the study: was to investigate the effectiveness of Percutaneous Needle Aspiration in comparison to continuous catheter drainage in the treatment of hepatic abscesses
Methods: A review of the scientific literature [From 1980 to October 2017] MEDLINE, EMBASE, SCOPUS, Current Contents, Cochrane Library, and Clinicaltrials.gov were searched to identify randomized controlled trials that investigated thoroughly the Percutaneous Needle Aspiration Versus Catheter Drainage in the treating of hepatic abscess and clearly met the inclusion criteria and the study primary endpoints [success rate, total resolution and mortality]. Identification of papers and data extraction were performed by independent researchers
Results: the search yielded six eligible RCTs covering 348 patients. The meta-analysis showed that outcomes in patients treated with PCD were superior to those in patients treated with PNA in terms of success rate [RR: 0.79, 95% CI=0.64-0.97; P = 0.04], days to achieve a 50% reduction in abscess cavity size [SMD: ?1.076, 95% CI 0.63-1.51; P < 0.00001] and overall clinical improvement [SMD: 0.71, 95% CI 0.35-1.09; P =0.0001]. On the other hand, no significant difference was notable in the duration of hospitalization [SMD: -0.15, 95% CI -2.03 to 1.72, P = 0.84] or procedure-related complications [RR: 0.48, 95% CI 0.13-2.58; P = 0.39]
Conclusion: The results of the present meta-analysis and systematic review indicated that PCD and PNA can be less safe and less invasive methods for the treatment of hepatic abscesses yet PCD is suggested to be more advantageous and superior to PNA
ABSTRACT
Background: the utility and efficacy of prophylactic central neck dissection with total thyroidectomy for treatment of differentiated thyroid cancers has been debated in the literature over the past few decades. Proponents of prophylactic central neck dissection support its routine use with the notion that it reduces local recurrence, increases accuracy in TNM staging and reduces surgical morbidity associated with reoperation. Conversely, those against the use of routine prophylactic central neck dissection argue there was no clear evidence which showed a reduction in recurrence or added benefit to survival, while the procedure increased the risk for complications and morbidity. This article discussed the role of prophylactic central neck dissection in the setting of thyroid cancer and reviewed recently published literatures to evaluate efficacy and safety of this procedure.The papillary thyroid carcinoma [PTC] is the most common disorder with favorable prognosis around the world. PTC has 90% survival rate, but the most important challenge was the lymph node metastases that would result in disease recurrence. There is a debate about the utility of prophylactic central neck dissection in the area of PTC. The available studies for performing PCND showed a difficulty in predicting its outcomes, but PCND could provide potential reduction in the recurrence rates and risks of performing another surgery in the neck. This review discussed the PCND advantages compared to its long term outcomes and morbidity