A systematic review of robot-assisted anti-reflux surgery to examine reporting standards

Abstract Robot-assisted anti-reflux surgery (RA-ARS) is increasingly being used to treat refractory gastro-oesophageal reflux disease. The IDEAL (Idea, Development, Exploration, Assessment, Long-term follow up) Collaboration’s framework aims to improve the evaluation of surgical innovation, but the extent to which the evolution of RA-ARS has followed this model is unclear. This study aims to evaluate the standard to which RA-ARS has been reported during its evolution, in relation to the IDEAL framework. A systematic review from inception to June 2020 was undertaken to identify all primary English language studies pertaining to RA-ARS. Studies of paraoesophageal or giant hernias were excluded. Data extraction was informed by IDEAL guidelines and summarised by narrative synthesis. Twenty-three studies were included: two case reports, five case series, ten cohort studies and six randomised controlled trials. The majority were single-centre studies comparing RA-ARS and laparoscopic Nissen fundoplication. Eleven (48%) studies reported patient selection criteria, with high variability between studies. Few studies reported conflicts of interest (30%), funding arrangements (26%), or surgeons’ prior robotic experience (13%). Outcome reporting was heterogeneous; 157 distinct outcomes were identified. No single outcome was reported in all studies.The under-reporting of important aspects of study design and high degree of outcome heterogeneity impedes the ability to draw meaningful conclusions from the body of evidence. There is a need for further well-designed prospective studies and randomised trials, alongside agreement about outcome selection, measurement and reporting for future RA-ARS studies

Linguistic Co-existence in Constantinople: Greek and Latin (and Syriac) in the Acts of the Synod of 536 C.E.

This paper considers the interplay of Latin and Greek in the workings of both State and Church in sixth-century Constantinople, and the way that these two languages are represented in the written records of each. The richest source of evidence is provided by the Acts of the Church Councils and Synods, because at the end of a session, or of a multi-authored document, it was the custom for those involved to make a one-sentence statement of assent in their own handwriting. These processes also leave room for reflections of the use of Syriac (but not for items of actual Syriac text), but of no other language.</jats:p