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Zhang CR, Xu SY, Lv YC, Du BB, Wu DW, Li JJ, Zhu CZ, Yang XF. [Transanal drainage tube for prevention of anastomotic leak after anterior resection for rectal cancer: a meta-analysis]. Zhonghua Wei Chang Wai Ke Za Zhi 2023; 26:689-696. [PMID: 37583027 DOI: 10.3760/cma.j.cn441530-20221125-00493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 08/17/2023]
Abstract
Objective: To assess the effectiveness of transanal drainage tube (TDT) in reducing the incidence of anastomotic leak following anterior resection in patients with rectal cancer. Methods: We conducted a systematic search for relevant studies published from inception to October 2022 across multiple databases, including PubMed, Embase, Web of Science, Cochrane Library, CNKI, Wanfang, and VIP. Meta-analysis was performed using Review Manager 5.4 software. The primary outcomes included total incidence of anastomotic leak, grade B and C anastomotic leak rates, reoperation rate, anastomotic bleeding rate, and overall complication rate. Results: Three randomized controlled trials involving 1115 patients (559 patients in the TDT group and 556 in the non-TDT group) were included. Meta-analysis showed that the total incidences of anastomotic leak and of grade B anastomotic leak were 5.5% (31/559) and 4.5% (25/559), respectively, in the TDT group and 7.9% (44/556) and 3.8% (21/556), respectively, in the non-TDT group. These differences are not statistically significant (P=0.120, P=0.560, respectively). Compared with the non-TDT group, the TDT group had a lower incidence of grade C anastomotic leak (1.6% [7/559] vs. 4.5% [25/556]) and reoperation rate (0.9% [5/559] vs. 4.3% [24/556]), but a higher incidence of anastomotic bleeding (8.2% [23/279] vs. 3.6% [10/276]). These differences were statistically significant (P=0.003, P=0.001, P=0.030, respectively). The overall complication rate was 26.5%(74/279) in the TDT group and 27.2% (75/276) in the non-TDT group. These differences are not statistically significant (P=0.860). Conclusions: TDT did not significantly reduce the total incidence of anastomotic leak but may have potential clinical benefits in preventing grade C anastomotic leak. Notably, placement of TDT may increase the anastomotic bleeding rate.
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Affiliation(s)
- C R Zhang
- Department of Anorectal Surgery, Gansu Provincial People's Hospital, Lanzhou 730000, China Clinical Research Center for Anorectal Diseases of Gansu Province, Lanzhou 730000, China Clinical Medical College of Ningxia Medical University, Yinchuan 750000, China
| | - S Y Xu
- Department of Anorectal Surgery, Gansu Provincial People's Hospital, Lanzhou 730000, China Clinical Research Center for Anorectal Diseases of Gansu Province, Lanzhou 730000, China
| | - Y C Lv
- Department of Anorectal Surgery, Gansu Provincial People's Hospital, Lanzhou 730000, China Clinical Research Center for Anorectal Diseases of Gansu Province, Lanzhou 730000, China
| | - B B Du
- Department of Anorectal Surgery, Gansu Provincial People's Hospital, Lanzhou 730000, China Clinical Research Center for Anorectal Diseases of Gansu Province, Lanzhou 730000, China
| | - D W Wu
- Department of Anorectal Surgery, Gansu Provincial People's Hospital, Lanzhou 730000, China Clinical Research Center for Anorectal Diseases of Gansu Province, Lanzhou 730000, China
| | - J J Li
- Department of Anorectal Surgery, Gansu Provincial People's Hospital, Lanzhou 730000, China Clinical Research Center for Anorectal Diseases of Gansu Province, Lanzhou 730000, China
| | - C Z Zhu
- Department of Anorectal Surgery, Gansu Provincial People's Hospital, Lanzhou 730000, China Clinical Research Center for Anorectal Diseases of Gansu Province, Lanzhou 730000, China
| | - X F Yang
- Department of Anorectal Surgery, Gansu Provincial People's Hospital, Lanzhou 730000, China Clinical Research Center for Anorectal Diseases of Gansu Province, Lanzhou 730000, China
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Du BB, Bigelow PL, Wells RP, Davies HW, Hall P, Johnson PW. The impact of different seats and whole-body vibration exposures on truck driver vigilance and discomfort. Ergonomics 2018; 61:528-537. [PMID: 28845747 DOI: 10.1080/00140139.2017.1372638] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/07/2017] [Accepted: 08/21/2017] [Indexed: 06/07/2023]
Abstract
Laboratory studies have shown that exposure to whole-body vibration (WBV) increases physical and mental fatigue, which are common issues professional drivers face. The objective of this study was to determine whether altering WBV exposures had any effect on driver vigilance and discomfort. A repeated measures crossover design of five truck drivers with regular 10-h routes was used. Active and passive suspension truck seats were evaluated. For each seat, WBV exposures were measured. Participants completed a discomfort questionnaire and a reaction time task before and after their shift for two weeks, one week per seat. Compared with the passive seat, the active seat significantly reduced WBV exposures, decrements in the optimal and mean reaction times (p = 0.02, 0.047, respectively), and discomfort in the lower back and wrist(s)/forearm(s) (p < 0.01, 0.01, respectively). Study results indicated that reducing WBV helps reduce discomfort and maintain vigilance, which may improve drivers' health and reduce the risk of truck collisions. Practitioner Summary: The active suspension seat used in this study reduced truck drivers' exposure to whole-body vibration (WBV) by over 33% in relation to their current industry standard passive suspension seat. This study demonstrated that reducing truck drivers' exposure to WBV reduced fatigue and discomfort development over a workday.
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Affiliation(s)
- Bronson Boi Du
- a Faculty of Applied Health Science, School of Public Health and Health Systems , University of Waterloo , Waterloo , Canada
| | - Philip L Bigelow
- a Faculty of Applied Health Science, School of Public Health and Health Systems , University of Waterloo , Waterloo , Canada
| | - Richard P Wells
- b Faculty of Applied Health Science, Department of Kinesiology , University of Waterloo , Waterloo , Canada
| | - Hugh W Davies
- c School of Population and Public Health , University of British Columbia , Vancouver , Canada
| | - Peter Hall
- b Faculty of Applied Health Science, Department of Kinesiology , University of Waterloo , Waterloo , Canada
| | - Peter W Johnson
- d Department of Environmental and Occupational Health and Safety , University of Washington , Seattle , WA , USA
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