Background: Conventional multi-port laparoscopic cholecystectomy (CMLC) has become the current ‘gold standard’ technique in gallbladder disease. Single-incision laparoscopic cholecystectomy (SILC) has gained attention due to its benefits in improving patient cosmetic results and pain reduction. We aim to assess the latest evidence on the feasibility, safety and surgical outcomes of SILC and CMLC. Methods: We conducted searches for randomized controlled trials (RCTs) in PubMed, PubMed Central (PMC), and Europe PMC between December 2011 and 2021. The latest search was conducted in January 2022. We analyzed several outcomes, including perioperative complications, estimated blood loss, operation time, conversion to open surgery, hospital stay, pain score, cosmesis, and days of return to work. Cochrane Risk of Bias (RoB) 2.0 tool was used to evaluate quality of studies. Mantel-Haenszel's formula and Inverse Variance method were conducted to synthesize results. This study was accomplished in accordance with the PRISMA guidelines. Results: A total of 37 studies were eligible, with a total of 2,129 and 2,392 patients who underwent SILC and CMLC. Our study demonstrated a superiority of SILC for the visual analog score (VAS) at six hours post-operation [mean difference (MD) -0.58 (95% CI -1.11, -0.05), p=0.03], cosmesis one-month post-operation [standard MD 2.12 (95% CI 1.10, 3.13), p<0.0001], and cosmesis six months post-operation [standard MD 0.53 (95% CI 0.06, 0.99), p<0.0001]. Meanwhile, SILC showed a longer operation time [MD 10.45 (95% CI 6.74, 14.17), p<0.00001]. In terms of VAS at four time points (4, 8, 12, and 24 hours), perioperative complications, estimated blood loss, conversion to open surgery, hospital stay and days to return to work, SILC did not differ from CMLC. Conclusions: SILC is a safe, feasible and favorable procedure in terms of pain reduction and cosmetic results. The option between both procedures is based on surgeon preferences. Registration: PROSPERO (CRD42022306532; 23 February 2022).

BackgroundThe possibilities of minimally invasive cholecystectomy have emerged since the beginning of single‐incision laparoscopic cholecystectomy (SILC) and single‐site robotic cholecystectomy (SSRC). This study aimed to compare the feasibility, safety, and pain scores between SSRC and SILC.MethodsThe authors searched randomized or non‐randomized controlled trials and observational studies in PubMed, EuroPMC, and ClinicalTrials.gov from April 2012 until April 2022. The authors analyzed the operation time, hospital stay, blood loss volume, conversion rate, intraoperative complication rates, postoperative complications, visual analog scale (VAS) immediately after surgery, and VAS at hospital discharge. This study aligned with PRISMA and AMSTAR guidelines.ResultsThirteen studies were selected with 817 and 757 patients who underwent SSRC and SILC. Thus, this study demonstrated a lower incidence of intraoperative complication rates [relative risk (RR) 0.57 (95% CI 0.34–0.96), p = 0.03] and lesser VAS score at hospital discharge [Std. Mean Difference (SMD) −0.23 (95% CI −0.46, −0.01), p = 0.04] in the SSRC group. Regarding operation time and cost, SSRC revealed a longer time [SMD 1.02 (95% CI 0.45, 1.59), p = 0.0004] and higher cost [SMD 4.18 (95% CI 1.77, 6.58), p < 0.00001], respectively. Meanwhile, SSRC did not differ from SILC during a hospital stay, blood loss volume, conversion rate, postoperative complication rates, and VAS immediately after surgery.ConclusionsConcerning intraoperative complication rates and VAS score at hospital discharge, SSRC was superior to SILC. Thus, SSRC is considered a feasible and safe procedure.

Pain and wound after haemorrhoidectomy constantly bothered the patient's convenience. Recurrently, topical sucralfate is used to treat excoriations and burns. It is considered to enhance epidermal growth and tissue granulation, thus, alleviating patients' problems. This study evaluated topical sucralfate's feasibility, safety, and superiority after haemorrhoidectomy. We searched randomised controlled trial (RCT) studies in PubMed, Google Scholar, Europe PMC, and ClinicalTrials.gov until March 29th, 2022. We investigated the influence of topical sucralfate on pain score postoperatively (24 hours, 7 days, and 14 days), pethidine usage, diclofenac usage, and wound healing rate compared to placebo. This study was conducted following the PRISMA guidelines. This study sorted the final six studies with 439 patients underwent haemorrhoidectomy. Topical sucralfate demonstrated significant outcomes on VAS 24 hours post-operative [Std. Mean Difference À1.00 (95% CI À1.70, À0.31), P = .005], VAS 7 days post-operative [Std. Mean Difference À2.29 (95% CI À3.34, À1.25), P < .0001], VAS 14 days post-operative [Std. Mean Difference À1.88 (95% CI À2.74, À1.01), P < .0001], pethidine usage within 24 hours post-operative [Std. Mean Difference À0.62 (95% CI À0.96, À0.27), P = .0004], diclofenac usage 7 days post-operative [Std. Mean Difference À1.76 (95% CI À2.61, À0.92), P < .0001], diclofenac usage 14 days post-operative [Std. Mean Difference À1.64 (95% CI À2.38, À0.91), P < .0001], and wound healing rate at 28-day post-operative [RR 1.45 (95% CI 1.25-1.68), P < .00001]. Topical sucralfate alleviated pain, improved wound healing, and minimised the usage of pethidine and diclofenac compared to placebo.

Breast cancer (BC) is a heavy burden for Indonesian healthcare, but there is still no thorough evaluation for Breast self-examination (BSE) practice as routine BC screening. In this study, we aimed to synthesize the pooled prevalence data of BSE practice, compare BSE practice prevalence between Java Island and non-Java Islands in Indonesia, and identify the determinants that we thought could affect the BSE practice in the Indonesian population. Intensive searches were conducted in Cochrane Library, PubMed, Google Scholar, and SINTA (Indonesian Web of Science and Technology Index) from September 2017–2022. We utilized Review Manager 5.4 for conducting the meta-analysis. We found the overall national prevalence of BSE practice was 43.14% (95% CI: 36.08, 50.20, p < 0.00001). BSE practice in Java Island was higher compared to non-Java Island (44.58% vs. 41.62%). The highest prevalence of BSE practice was found among university students, with a 49.90% prevalence. Good knowledge, good attitude toward BSE, family history of BC, family support, and BC information exposure were all statistically associated with a higher determinant of BSE practice. We concluded that BSE practice in Indonesia is still low, especially in non-Java Islands. Integrative and collaborative programs should be established to promote BSE as routine screening for BC.