Background/Aim: This study aimed to compare neoadjuvant chemotherapy (NAC) followed by interval debulking surgery (IDS) with primary debulking surgery (PDS) followed by chemotherapy in patients with advanced ovarian carcinoma International Federation of Gynecology and Obstetrics (FIGO) stages IIIc and IV. Methods: PubMed, the Cochrane Library, and manual searches were applied to discriminate potentially eligible studies published before June 30, 2016. Results: A total of 12 comparative studies were finally included; 1,372 patients underwent NAC followed by IDS, and 2,680 patients underwent PDS followed by chemotherapy. For overall pooled estimates, significant between-trial differences were found in the optimal debulking rate, grade 3–5 postoperative adverse reactions, and median overall survival (OS), but no difference was found in the median progression-free survival (PFS). Moreover, a significantly higher incidence was identified in major infections, vascular events, and wound complications for patients in the PDS group. Conclusions: This study suggested that NAC followed by IDS could improve the optimal debulking rate and decrease the postoperative adverse reactions for the current studies, but whether it could improve the OS and PFS compared with PDS followed by chemotherapy in patients with ovarian carcinoma FIGO stages IIIc and IV were still needed to be verified by conducting more randomized controlled trials.
Background: External cephalic version (ECV) has been proved effectively in reducing the cesarean section rates, but the success rates of the procedure are uneven. Experiences of ECV with high success rate were concluded in this paper. And in order to evaluate the efficiency of the applied tocolytic agents, a corresponding bayesian-network meta-analysis was conducted.Methods: Through retrospective analysis of eighty-four single pregnant women with breech presentation near or at term who received ECV from Dalian Maternal and Child Health Care Hospital from April 2017 to November 2019, influence factors associated with the success rate of ECV were analyzed. Meanwhile, a bayesian-network meta-analysis including sixteen eligible randomized controlled trials (RCTs) about comparisons of five common tololytic agents and placebo with 3468 participants searched from Pubmed, Cochrane library and Embase databases until May 20, 2019 was conducted to identify the efficiency of ritodrine and terbutaline applied in the authors’ procedures. Results: The ECV procedures were conducted by a skilled obstetrician through strict selection of the candidates. Oral ritodrine, intravenous terbutaline in combination with epidual analgesia were applied as interventions. Success rate of ECV reached 90.48% (76/84) and the overall vaginal delivery rate is up to 88.16% (67/76). Only one patient reverted to breech presentation due to loose of the bellyband. Among the possible variables, amniotic fluid index were identified to have significantly relationship with the success rate of ECV. As the bayesian network meta-analysis proved: terbutaline, salbutamol and ritodrine played more important roles than nitroglycerine and nifedipine on the success rate of ECV. But salbutamol was found to have more common side effects than terbutaline and ritodrine.Conclusions: We conclude that factors influencing the success rate of ECV mainly include: 1. characteristics of the mothers and fetuses, 2. interventions, 3. skills of the surgeon. During ECV process, selection of patients with enough amniotic fluid and proper stature with no contraindications is essential. And a more detailed scoring standard according to the possible influence indicators of the mothers and fetuses for the feasibility of ECV should be set up in the future. Besides, application of terbutaline and ritodrine as tocolytic agents during ECV procedure were considered to be effective for increasing successful versions.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.