Endoscopic or laparoscopic resection for small gastrointestinal stromal tumors: a cumulative meta-analysis / 中华医学杂志(英文版)

BACKGROUND@#Despite the recent large number of studies comparing endoscopic and laparoscopic resection for small gastrointestinal stromal tumors (GISTs) (diameter ≤ 5 cm), the results remain conflicting. The objective of this work was to perform a cumulative meta-analysis to assess the advantages and disadvantages of endoscopic resection vs. laparoscopic resection.@*METHODS@#The meta-analysis followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. We searched medical databases up to January 2020. Meta-analytical random or fixed effects models were used in pooled analyses. Meta-regression, cumulative meta-analyses, and subgroup analyses were performed to improve the accuracy of the conclusion. Sensitivity analyses were applied to assess the robustness of the results.@*RESULTS@#A total of 12 cohort studies with 1383 participants comparing endoscopic resection and laparoscopic resection were identified, while three cohort studies with 167 participants comparing endoscopic resection and laparoscopic and endoscopic cooperative surgery were found. We found that endoscopic resection had shorter operation times (weighted mean difference [WMD] = -27.1 min, 95% confidence interval [CI]: -40.8 min to -13.4 min) and lengths of hospital stay (WMD = -1.43 d, 95% CI: -2.31 d to -0.56 d) than did laparoscopic resection. The results were stable and reliable. There were no significant differences in terms of blood loss, hospitalization costs, incidence of complications or recurrence rates. For tumor sizes 2 - 5 cm, endoscopic resection increased the risk of positive margins (relative risk [RR] = 5.78, 95% CI: 1.31 - 25.46). Although operation times for endoscopic resection were shorter than those of laparoscopic and endoscopic cooperative surgery (WMD = -41.03 min, 95% CI: -59.53 min to -22.54 min), there was a higher incidence of complications (RR = 4.03, 95% CI: 1.57 - 10.34).@*CONCLUSIONS@#In general, endoscopic resection is an alternative method for gastric GISTs ≤ 5 cm. Laparoscopic and endoscopic cooperative surgery may work well in combination. Further randomized controlled trials are recommended to validate or update these results.

An analysis on the quality of life and its determinants among residents along rivers in Wenzhou / 预防医学

Objective To assess the quality of life among residents along rivers in Wenzhou and to analyze its influencing factors.Methods Through stratified random sampling,228 residents from 6 residential districts along rivers in Wenzhou were evaluated by the Short -Form Health Survey (SF -36).Association between independent and dependent variables were assessed by the univariate analysis and forward multiple regression.Results In 21 0 residents along rivers,the score of Physiological Function was 96.67 (1 0.00),followed by Vitality(86.1 2 ±1 .06),Bodily Pain 80.00 (20.00),Role Physical 87.50 (25.00),Social Function 83.33 (1 6.67 ),Role Emotional 66.67 (33.33 ),Physical Health Summary (73.1 1 ±0.94),and Mental Health Summary (72.27 ±0.93 ).The water environmental pollution,as the foremost influencing factors,may has impact on the Physical Function,Role Physical,Bodily Pain,Social Function,Role Emotional,Physical Health Summary and Mental Health Summary of residents.Being the longer living time,the residents may have higher scores in Physical Health Summary,Physical Function,Role Physical,General Health and Vitality.The residents,who had higher social strata,may have higher scores in the Role Physical,Bodily Pain and General Health.The male residents had the higher scores in General Health.Conclusion There were significant effects of water environmental pollution on the quality of life among residents along rivers in Wenzhou.It is high time that the government managed the water pollution and propagated the knowledge of environmental protection to enhance the quality of life of residents along rivers.