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A reproducible framework for monitoring the impact of randomized clinical trials on clinical practice using large-scale real-world data: application to gynaecological surgical trials using the French national healthcare database.
EClinicalMedicine
February 2025
Department of Breast and Gynaecological Surgery, Institut Curie, Paris, France.
Background: Randomized clinical trials (RCTs) are fundamental to evidence-based medicine, but their real-world impact on clinical practice often remains unmonitored. Leveraging large-scale real-world data can enable systematic monitoring of RCT effects. We aimed to develop a reproducible framework using real-world data to assess how major RCTs influence medical practice, using two pivotal surgical RCTs in gynaecologic oncology as an example-the LACC (Laparoscopic Approach to Cervical Cancer) and LION (Lymphadenectomy in Ovarian Neoplasms) trials.
View Article and Find Full Text PDF[Sleeve gastrectomy for the surgical management of obesity at the Essos Hospital Center (Yaoundé, Cameroon): a retrospective case series study evaluating medium-term weight loss].
Pan Afr Med J
January 2025
Département de Chirurgie et Spécialités, Faculté de Médecine et des Sciences Biomédicales de l'Université de Yaoundé I, Yaoundé, Cameroun.
While the prevalence of overweight and obesity is rising in Africa, the practice of bariatric surgery remains limited in our country, Cameroon. Weight loss outcomes following sleeve gastrectomy (SG), the most widely used bariatric surgery technique worldwide, have not yet been studied in our context. The medical records of all patients who underwent SG in our surgery department between January 1, 2016, and September 30, 2020, were reviewed retrospectively.
View Article and Find Full Text PDFIntroduction: This study explored the effects of four different surgical methods in the treatment of cesarean scar pregnancy (CSP).
Methods: In this multicenter retrospective analysis of 359 patients, the surgical indices, the time taken for the serum human chorionic gonadotropin level to return to normal, the recovery time of menstruation, and the incidence of postoperative adverse reactions were comparatively analyzed. The clinical efficacies of various preoperative treatment methods to block the blood supply to CSP tissues and those of four different surgical methods to treat CSP, namely, curettage, hysteroscopic surgery, laparoscopic surgery, and vaginal surgery, were evaluated in this study.
Evaluating Infertility Through Diagnostic Hysterolaparoscopy: A Prospective Study.
Cureus
December 2024
Obstetrics and Gynaecology, Dr. D Y Patil Medical College, Hospital and Research Centre, Dr. D Y Patil Vidyapeeth (Deemed to be University) Pimpri, Pune, IND.
Background Infertility affects a significant proportion of reproductive-age couples globally, with diverse causes. Diagnostic hystero-laparoscopy (DHL) is emerging as a preferred diagnostic tool for evaluating infertility, combining laparoscopy and hysteroscopy for comprehensive assessment. Objective The primary objective of this prospective study was to evaluate the diagnostic accuracy and clinical utility of DHL in identifying the causes of infertility in women.
View Article and Find Full Text PDFIoC2 monitoring versus standard practice in reducing opioid consumption in elderly patients undergoing laparoscopic colorectal surgery: a study protocol for a randomised controlled trial.
BMJ Open
January 2025
Department of Anaesthesiology, China-Japan Friendship Hospital, Beijing, Beijing, China.
Introduction: Nociception monitoring has recently gained recognition as a valuable tool for guiding intraoperative opioid administration. Several nociception monitors, including the Surgical Pleth Index, the Index of Consciousness (IoC) and the Nociception Level, have been introduced for managing intraoperative analgesia. While these technologies show promise in initial applications, the effectiveness of IoC2 in guiding pain management during anaesthesia, particularly in elderly patients who require precise opioid use, remains unclear.
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