Anastomotic Leak and Perioperative Outcomes of Esophagectomy for Esophageal Cancer during the COVID-19 Pandemic: A Systematic Review and Meta-Analysis

Background and Objectives: The coronavirus disease-2019 (COVID-19) pandemic influenced the healthcare system tremendously, as well as the number of elective surgical procedures worldwide. The aim of this study is to investigate the COVID-19 pandemic's impact on esophagectomies. Materials and Methods: The MEDLINE (via PubMed), Cochrane Library, and Google Scholar bibliographical databases were systematically searched. Original clinical studies investigating the outcomes of esophageal cancer surgery during the COVID-19 pandemic were deemed eligible. After exclusion criteria were applied, eight studies were considered eligible for inclusion. Results: Eight studies with non-overlapping populations, reporting on patients undergoing esophagectomy for resectable esophageal cancer during the COVID-19 pandemic, were included in our analysis, with a total of 18548 patients. Background characteristics for age, lung disease, smoking history as well as Body Mass Index and age were equal among the groups. The background of diabetes presented a statistically significant difference among the groups. Perioperative outcomes like reoperation rates, the length of intensive care unit stay, or readmission rates were not significantly increased during the pandemic. The 30-day readmission, and 30- and 90-day mortality were not affected either. The length of hospital stay was significantly lower in the non-pandemic period. Conclusions: The results of our study support the evidence that in the context of the COVID-19 pandemic, esophageal cancer operations took place safely and effectively, similarly to the standards of the non-COVID-19 era.

945 EFFECTIVENESS OF CREATINE SUPPLEMENTATION ON MEMORY IN HEALTHY INDIVIDUALS: A SYSTEMATIC REVIEW AND META-ANALYSIS

Introduction

The benefit of creatine monohydrate supplementation in improving memory performance in healthy humans is unclear. The aim of this study was to determine the effectiveness of creatine monohydrate supplementation on memory performance in healthy humans.

Method

A literature search of PubMed, Web of Science, Cochrane Library, and Scopus for randomized clinical trials (RCTs) published from database inception until September 30, 2021, examining the effects of creatine supplementation on measures of memory in healthy humans was conducted. The control groups consisted of placebo. The main outcome was performance measures of memory that were further examined according to age, sex, treatment duration, and dose of creatine monohydrate supplementation.

Results

Ten RCTs met the inclusion criteria and 8 were included in the meta-analysis. Overall, creatine supplementation improved memory compared to placebo (SMD: 0.29, 95% CI: 0.04–0.53, I2 = 66%, P = 0.02). Subgroup analyses revealed a significant improvement on memory in older adults (66–76 years) (SMD: 0.88, 95% CI: 0.22–1.55, I2 = 83%, P = 0.009). Creatine dose, duration of intervention, and sex did not influence the findings.

Conclusion

These data support that the use of creatine monohydrate supplementation enhances memory performance in healthy humans compared to placebo, especially in older adults. However, caution is warranted due to the combination of various assessment tools designed to measure memory, which would increase the heterogeneity of the data.