Annals of Medicine and Surgery

COVID-19's daily increasing cases and deaths have led to worldwide lockdown, quarantine and some restrictions. This study aims to analyze the effect of lockdown days on the spread of coronavirus in countries. COVID-19 cases and lockdown days data were collected for 49 countries that implemented the lockdown between certain dates (without interruption). The correlation tests were used for data analysis based on unconstrained (normal) and constrained (Tukey-lambda). The lockdown days was significantly correlated with COVID-19 pandemic based on unconstrained (r = -0.9126, F-ratio = 6.1654; t-ratio = 2.40; prob > .0203 with 49 observations) and based on Tukey-lambda (r = 0.7402, λ = 0.14). The lockdown, one of the social isolation restrictions, has been observed to prevent the COVID-19 pandemic, and showed that the spread of the virus can be significantly reduced by this preventive restriction in this study. This study offers initial evidence that the COVID-19 pandemic can be suppressed by a lockdown. The application of lockdown by governments is also thought to be effective on psychology, environment and economy besides having impact on Covid-19.

INTRODUCTION: Strengthening The Reporting Of Cohort Studies in Surgery (STROCSS) guidelines were developed in 2017 in order to improve the reporting quality of observational studies in surgery and updated in 2019. In order to maintain relevance and continue upholding good reporting quality among observational studies in surgery, we aimed to update STROCSS 2019 guidelines. METHODS: A STROCSS 2021 steering group was formed to come up with proposals to update STROCSS 2019 guidelines. An expert panel of researchers assessed these proposals and judged whether they should become part of STROCSS 2021 guidelines or not, through a Delphi consensus exercise. RESULTS: 42 people (89%) completed the DELPHI survey and hence participated in the development of STROCSS 2021 guidelines. All items received a score between 7 and 9 by greater than 70% of the participants, indicating a high level of agreement among the DELPHI group members with the proposed changes to all the items. CONCLUSION: We present updated STROCSS 2021 guidelines to ensure ongoing good reporting quality among observational studies in surgery.

As medicine progresses into a new era of personalised therapy, the use of monoclonal antibodies to treat a wide range of diseases lies at the heart of this new forefront. Since the licencing of the first monoclonal antibody for clinical use 30 years ago, the monoclonal antibody industry has expanded exponentially and is now valued at billions of dollars. With major advances in genetic sequencing and biomedical research, much research into monoclonal antibodies now focuses on identifying new targets for development and maximising their efficacy for use in clinical practice. However, a balance has to be struck with regards to reducing numbers of side-effects and overall economic cost, which arguably somewhat blighted their early clinical and commercial successes. Nowadays, there are approximately 30 monoclonal antibodies that have been approved for use in clinical practice with many more currently being tested in clinical trials. Some of the current major limitations include: the use of inefficient models for generation, a lack of efficacy and issues of cost-effectiveness. Some of the current research focuses on ways to improve the efficacy of existing monoclonal antibodies through optimising their effects and the addition of beneficial modifications. This review will focus on the history of monoclonal antibody development - how it has increasingly moved away from using laborious animal models to a more effective phage display system, some of the major drawbacks from a clinical and economical point of view and future innovations that are currently being researched to maximise their effectiveness for future clinical use.

Background: Despite recent advances the pathogenesis of Crohn's disease remains incompletely understood. A variety of animal models have been utilized in an effort to provide further insights and develop more therapeutic options. In order to simulate, to an extent, the pathogenesis and the clinical course of the disease, TNBS induced colitis is often used. Various approaches for inducing TNBS -colitis have been described in the literature. Methods/results: In this review, we sought to present the animal model of TNBS induced colitis and outline the pathogenesis, pathophysiology, clinical course and pathological characteristics of the model. Furthermore, we describe the differences among those protocols regarding types of animals and colitis induction. Data sources: The MEDLINE database was thoroughly searched using the keywords: TNBS, colitis, Crohn's disease, animal model. Two investigators independently reviewed the abstracts and appropriate articles were included in this review. Additional articles were gathered and evaluated. Conclusion: The aim of this study was to thoroughly present an updated review of the TNBS-induced colitis protocols that are implemented by researchers. HIGHLIGHTS We sought to present the animal model of TNBS induced colitis and outline the pathogenesis, pathophysiology, clinical course and pathological characteristics of the model. Furthermore, we describe the differences among those protocols regarding types of animals and colitis induction. The MEDLINE database was thoroughly searched using the keywords: TNBS, colitis, Crohn's disease, animal model. Two investigators independently reviewed the abstracts and appropriate articles were included in this review. The aim of this study was to thoroughly present an updated review of the TNBS-induced colitis protocols that are implemented by researchers.

OBJECTIVE: To systematically review the procedure, applications, and outcomes of autologous fat grafting, a promising technique with various clinical applications. PATIENTS AND METHODS: Literature review of publications concerning autologous fat grafting. RESULTS: Since its introduction, lipofilling has become increasingly popular; however, its results are variable and unpredictable. Several modifications have been made to the procedures of fat harvesting, processing, and injecting. Surgical excision and low negative-pressure aspiration with large-bore cannulas minimize adipocyte damage during fat harvesting. The "wet" method of fat harvesting involves fluid injection at the donor site and facilitates lipoaspiration while minimizing pain and ecchymosis. For fat processing, centrifugation at a low speed is preferable to high-speed centrifugation, gravity separation or filtration. Fat injection at the recipient site should be performed using small-gauge cannulas in a fanning out pattern over multiple sessions, rather than a single session. Fat grafts exhibit not only dermal filler properties but also regenerative potential owing to the presence of stem cells in fat tissue. Thus, the clinical applications of autologous fat grafting include correction of secondary contour defects after breast reconstruction, release of painful scar contractures, and treatment of burn scars and radiodermatitis. Lipofilling is also used in aesthetic surgery, such as facial and hand rejuvenation, augmentation rhinoplasty, and breast and gluteal augmentation. The complications of lipofilling are minimal and include bruising, swelling, pain, infection, necrosis, and calcification. CONCLUSIONS: Lipofilling is a low-risk procedure that can be used to correct soft-tissue defects in the face, trunk, and extremities, with minimal discomfort for patients.

Emergence of coronavirus disease 2019 (COVID-19) forced the worldwide higher educational institutes to adopt distance learning mode. Further, remote electronic exams (E−exams) were considered as mode of assessment. Objectives: This cross-sectional study evaluated the students' experience of remote E-exams during the COVID-19 pandemic among Medical Sciences students in Jordan. Materials and Methods: A survey of 29 questions was prepared on Google forms and distributed among students at Faculties of Medical Sciences (Medicine, Dentistry, Pharmacy, Nursing and Applied Medical Sciences) at Jordan University of Science and Technology. The questions include students' demographics, stress experience, and factors contributing to stress as well as behavioral changes related to remote E-exams. Responses were analyzed using descriptive, cross tabulation and Chi-square tests. Results: Among 1019 respondents, 32% reported more stress with remote E-exams. This was associated with academic major and gender. Among students with more stress during remote E-exams, the exam duration, mode of questions navigation and technical problems (exam platform and internet connectivity) appeared as the main factors related to stress in 78%, 76% and >60%, respectively. Other factors include concern regarding the teaching methods, exam environment and students' dishonesty. Remote E-exams had negative impact on students' dietary habits (increase consumption of caffeine and high energy drinks, high sugar food, fast food), sleep (reduction in sleeping hours, more consumption of insomnia medications), physical activity (less exercises) and smoking habits (increase). Conclusion: Results suggested a negative impact of E-exams on students within Medical Faculties. Robust exam platform and remote mock E-exams are recommended to reduce students' potential stress. A stress-free environment is very essential to encourage students to adopt remote E-exams, particularly if the pandemic will take longer. Various awareness programs about students' habits related to dietary, sleep quality, physical activity and smoking are highly valuable for students’ health benefits. This is of particular importance since the current students at Faculties of Medical Sciences are the future health care providers.

BACKGROUND: Many surgeons experience work-related pain and musculoskeletal symptoms; however, comprehensive reporting of surgeon ailments is lacking in the literature. We sought to evaluate surgeons' work-related symptoms, possible causes of these symptoms, and to report outcomes associated with those symptoms. MATERIALS AND METHODS: Five major medical indices were queried for articles published between 1980 and 2014. Included articles evaluated musculoskeletal symptoms and ergonomic outcomes in surgeons. A meta-analysis using a fixed-effect model was used to report pooled results. RESULTS: Forty articles with 5152 surveyed surgeons were included. Sixty-eight percent of surgeons surveyed reported generalized pain. Site-specific pain included pain in the back (50%), neck (48%), and arm or shoulder (43%). Fatigue was reported by 71% of surgeons, numbness by 37%, and stiffness by 45%. Compared with surgeons performing open surgery, surgeons performing minimally invasive surgery (MIS) were significantly more likely to experience pain in the neck (OR 2.77 [95% CI 1.30-5.93]), arm or shoulder (OR 4.59 [2.19-9.61]), hands (OR 2.99 [1.33-6.71], and legs (OR 12.34 [5.43-28.06]) and experience higher odds of fatigue (8.09 [5.60-11.70]) and numbness (6.82 [1.75-26.65]). Operating exacerbated pain in 61% of surgeons, but only 29% sought treatment for their symptoms. We found no direct association between muscles strained and symptoms. CONCLUSIONS: Most surgeons report work-related symptoms but are unlikely to seek medical attention. MIS surgeons are significantly more likely to experience musculoskeletal symptoms than surgeons performing open surgery. Symptoms experienced do not necessarily correlate with strain.

INTRODUCTION: In the spot of the new emerging COVID-19 pandemic and its major impact worldwide on day-to-day activities many rules had to be changed in order to fight this pandemic. Lockdown started in Jordan and around the globe affecting several aspects of life including economy, education, entertainment, and government policies. Regarding education, the priority was to ensure the safety and progress of the educational process. Thus, new methods of teaching had to be applied using the online learning at Jordan University of Science and Technology (JUST), Faculty of Medicine. This study was done to assess (1) Class Experience (2) Students and Lecturers' Interaction (3) Online Learning Advantages & Disadvantages (4) Students' Preference. METHODS: A cross sectional study was conducted Convenience sampling technique was used to collect the data from the participants using a survey composed of 18 questions on Google Forms platform. A link was sent to the undergraduate medical students at the Jordan University of Science & Technology via their e-learning accounts (n = 3700). The form was available from May 22nd, 2020 to May 30th, 2020 for 8 days long. Data analysis was done using SPSS V 23. RESULTS: 2212 out of 3700 students responded, (55.8%) of them were in the basic years and (44.2%) of them were in the clinical years. (55.8%) of students started to take online lectures after 3 weeks. (45.7%) used the hybrid teaching method (asynchronous and synchronous), (31.4%) used live classes, and 22.8% recorded classes. Zoom was the most used platform. (48.7%) and (57%) of clinical students and basic students express their interaction as bad, while the others had good and excellent interaction. Maintaining social distance was the most advantage of online teaching, while poor technical setup and no direct contact were the most disadvantage, furthermore inability to have real clinical access was a significant problem for clinical students (p < .001). With reference to students' preferences 75% of students were not pleased with their experience and 42% of students prefer to integrate online learning with traditional learning. CONCLUSION: Most medical students at JUST preferred the traditional face-to-face teaching method over the solo online teaching methods with recommendations to convert to a more integrated educational system. Also, a well-established infrastructure should be done in involving online teaching.

Students often feel overwhelmed by the volume and complexity of knowledge and skills required to learn. Along with this challange, educational technology has been gradually introduced in medical education to facilitate learning and improve outcomes. It became an essential part of communication, storing and transferring information, audio-visual media use and production, and knowledge sharing. Technology's role has been expanding from a mere tool of study and inquiry to an approach and integrated use in education. Its use in medical education is continuously evolving. However, the impact and optimal use of various technology applications are not clearly defined. There are multiple challenges facing educators to choose the right application for the specific educational purpose. Hence, studies and evaluation reviews are needed to inform the better-defined use of educational technology. This review aims to discuss and evaluate various educational technology applications in medical education, focusing on interactive learning during lectures. Lectures and other group learning sessions are common activities used by medical schools. Promoting interactive learning in large groups is known to be challenging. The advances in technology to facilitate communication and promote interaction is a promising adjunct for lectures interactivity.

Violence at work refers to acts or threats of violence directed against employees, either inside or outside the workplace, from verbal abuse, bullying, harassment, and physical assaults to homicide. Even though workplace violence has become a worrying trend worldwide, the true magnitude of the problem is uncertain, owing to limited surveillance and lack of awareness of the issue. As a result, if workplace violence, particularly in healthcare settings, is not adequately addressed, it will become a global phenomenon, undermining the peace and stability among the active communities while also posing a risk to the population's health and well-being. Hence, this review intends to identify the risk factors and the implications of workplace violence in healthcare settings and highlight the collaborative efforts needed in sustaining control and prevention measures against workplace violence. HIGHLIGHTS Workplace violence needs to be addressed more comprehensively, involving shared responsibilities from all levels. Emphasis on healthcare management's commitment, assurance, and clearly defined policy, reporting procedures, and training. The healthcare workers’ commitment to update their awareness and knowledge regarding workplace violence. The provision of technical support and assistance from professional organizations, NGOs, and the community.

Introduction and importance: Intravesical Bacillus Calmette–Guérin (BCG) therapy is commonly used as an adjuvant therapy for certain non-invasive bladder cancers following transurethral resection of bladder tumor. Rarely, this treatment can lead to the formation of granulomatous masses in the kidney, with vesicoureteral reflux following BCG being a possible etiology for their development. Case presentation: We report a case of an 82-year-old man with a history of non-muscle-invasive bladder cancer treated with intravesical BCG who was found to have bilateral renal masses on imaging. The patient presented to the hospital after an adverse reaction to intravesical BCG and complained of fever, fatigue, and decreased appetite. Clinical discussion: The lesions were initially suspicious for malignancy; however, histopathologic evaluation revealed benign granulomatous lesions consistent with a BCG-related immune response. This rare presentation was monitored closely with acid-fast bacilli cultures and polymerase chain reaction tests. Mycobacterium bovis was subsequently identified in urine cultures. Conclusion: This case report highlights the plausibility of benign renal granulomas as part of the differential diagnosis for patients undergoing BCG immunotherapy who present with renal masses. Awareness of this rare complication may help prevent unnecessary surgical intervention and guide appropriate and timely management. Non-invasive diagnostic strategies, such as a biopsy or close imaging follow-up, should be considered in clinically stable patients.

Introduction and importance: Neurofibromatosis type 1 (NF1) is a genetic disorder characterized by peripheral nerve sheath tumors in the skin or nervous system. Its prevalence is 1 in 2600-3000 individuals, but intra-abdominal manifestations appear in only 5-25% of these patients, which makes this presentation a rare medical condition. The presence of intra-abdominal lesions can significantly complicate surgical procedures and render biliary reconstruction technically challenging. Case presentation: This case describes an uncommon presentation of visceral NF1 in a 75-year-old woman with cutaneous NF1 lesions, who was admitted to our hospital with right upper quadrant pain and jaundice. Preoperative imaging studies showed a dilated and tortuous common bile duct, filled with multiple stones. Because of prior unsuccessful endoscopic retrograde cholangiopancreatography procedures, an elective choledochotomy was performed. During surgery, widespread intra-abdominal neurofibromas were noted throughout the small intestine, posing significant difficulty in finding a suitable, tumor-free site for biliary-enteric anastomosis. Clinical discussion: Visceral involvement in NF1 is rare but can present major diagnostic and surgical challenges. Gastrointestinal neurofibromas may remain asymptomatic until they cause obstruction, bleeding, or jaundice. Surgical management demands special consideration when neurofibromas diffusely infiltrate the mesentery or bowel wall, as they complicate both exposure and reconstruction. The main challenge of this case was finding an area without neurofibroma lesions in the small intestine for anastomosis to prevent postoperative complications. Conclusion: This case highlights the importance of managing patients with gastrointestinal manifestations of NF1 who require abdominal surgical intervention.

Background: Mucocutaneous manifestations affect more than 80% of patients with systemic lupus erythematosus (SLE) and are frequently refractory to standard therapy, contributing to a substantial disease burden. Although belimumab improves overall SLE activity, its specific efficacy in the mucocutaneous domain warrants detailed evaluation. Objective: To evaluate the efficacy of belimumab for mucocutaneous manifestations in patients with active SLE. Methods: Systematic review and meta-analysis of Phase III trials. Quantitative mucocutaneous efficacy data were derived from published pooled individual patient data (IPD) post hoc analyses of these trials (BLISS-52, BLISS-76, BLISS-SC, BLISS-NEA, EMBRACE; N = 3645). Databases (PubMed, Embase, CENTRAL, ClinicalTrials.gov) were searched through December 2025. The primary outcome was the SLE Responder Index-4 (SRI-4) response at week 52. Mucocutaneous outcomes [improvement in mucocutaneous BILAG (mcBILAG) and mucocutaneous SLEDAI-2 K (mcSLEDAI-2 K), sustained improvement, flare prevention, and item-level resolution] were assessed using recent pooled post hoc analyses. Results: Belimumab significantly improved SRI-4 response [pooled odds ratio (OR), 1.58; 95% confidence interval (CI), 1.36–1.83; P < 0.00001]. In patients with baseline mucocutaneous involvement, belimumab was superior to placebo in inducing mcBILAG improvement (OR, 1.29; 95% CI, 1.07–1.57), mcSLEDAI-2 K improvement (OR, 1.37; 95% CI, 1.16–1.62), and sustained mcBILAG response [hazard ratio (HR), 1.23; 95% CI, 1.07–1.41]. Greater benefits were observed in subgroups with high baseline disease activity (SLEDAI-2 K 10) or serological activity (positive anti-dsDNA). Item-level resolution favored belimumab for rash, alopecia, and mucosal ulcers. Conclusion: Belimumab, added to standard therapy, significantly enhances global SLE control and provides consistent, sustained improvement in mucocutaneous manifestations, particularly in patients with higher disease activity or serological positivity. These data support belimumab as an effective option for refractory mucocutaneous SLE.

Introduction: Pediatric acute ischemic stroke (AIS) is an uncommon yet critical condition with a pooled incidence rate of 1.28 per 100 000 person-years. Unlike adult strokes, pediatric AIS often lacks standardized recognition protocols and presents with non-specific symptoms such as dizziness and vomiting, which can lead to significant diagnostic delays. Case presentation: We report the case of a previously healthy 7-year-old boy presenting with dizziness and projectile vomiting, followed by transient neurological deficits including quadriparesis and dysphagia. While the initial physical examination in the emergency department showed only gait ataxia, subsequent neuroimaging confirmed multifocal acute infarctions in the right cerebellum, right pons, and right posterior cerebral artery territory. Despite normal MR angiography, the distribution suggested a posterior circulation event. The patient was managed with antiplatelet therapy (aspirin 4 mg/kg/day, later titrated to 1 mg/kg/day) and supportive care. Further etiological workup for monogenic vasculopathies and thrombophilia was limited by parental preference. Conclusion: Pediatric AIS should be a primary consideration in the differential diagnosis for children with acute, unexplained neurological deficits, even when motor power appears preserved on initial examination. This case highlights the diagnostic challenge of posterior circulation strokes and the necessity of considering rare genetic vasculopathies such as DADA2 in idiopathic cases. Categories: Pediatrics.

Background: Respiratory compromise requiring ventilatory support is common in acute decompensated heart failure (ADHF). Noninvasive ventilation (NIV) may improve outcomes and reduce mortality compared with invasive mechanical ventilation (IMV). This study evaluated the association between ventilation modality and 30-day all-cause readmission. Methods: Using data from the 2016–2017 Nationwide Readmissions Database, adults aged 18 years or older who were hospitalized with a principal diagnosis of ADHF and received ventilatory support were identified. The primary outcome was 30-day all-cause readmission. Secondary outcomes included in-hospital mortality, length of stay, hospitalization charges, and discharge disposition. Results: Among 74 431 included patients, IMV use was linked to significantly worse in-hospital outcomes. In-hospital mortality was higher with IMV (33 vs. 6.6%; P < 0.001). Median length of stay was longer (10 vs. 5 days; P < 0.001), and hospitalization charges were greater ($124 832 vs. $43 298; P < 0.001). Non-home discharges were more frequent in the IMV group (62 vs. 34%; P < 0.001). Despite these adverse findings, IMV patients had lower 30-day all-cause readmission rates compared with NIV (14 vs. 19%; P < 0.001). Conclusion: IMV in ADHF is associated with higher mortality, longer hospitalizations, and increased costs but lower 30-day readmissions. Hospitals caring for these sicker patients, often teaching institutions, may face disproportionate financial penalties. Risk adjustment of Hospital Readmission Reduction Program metrics for ventilation modality and discharge disposition should be considered.

Introduction: Migratory polyarthralgia often indicates inflammatory or autoimmune pathology. In patients with concomitant allergic diathesis and immune dysregulation, diagnosis becomes particularly challenging, as conventional laboratory and serological evaluations frequently remain inconclusive. Nuclear medicine, particularly three-phase 99mTc-MDP bone scintigraphy with SPECT/CT, offers functional insights that overcome these limitations by directly visualizing bone metabolic activity, independent of serological status. Case presentation: A 27-year-old woman with bronchial asthma and allergic bronchopulmonary aspergillosis (ABPA) presented with an 11-month history of migratory polyarthralgia. Her background included recurrent anaphylaxis, multiple prior viral infections, and significant systemic corticosteroid exposure (intravenous methylprednisolone 40 mg/day for 10 days, followed by oral methylprednisolone 30 mg three times daily, with subsequent tapering over a total course from September to November 2024), resulting in cushingoid features. Three-phase 99mTc-MDP bone scintigraphy demonstrated increased tracer uptake across multiple joints, consistent with inflammatory arthropathy, and SPECT/CT correlation revealed multifocal avascular necrosis (AVN) and subclinical synovitis in the bilateral femoral heads, elbows, wrists, knees, and ankles. MRI of the right knee and both hips provided anatomical confirmation. Clinical discussion: This case illustrates the diagnostic utility of bone scintigraphy in immune-allergic overlap syndromes in which conventional investigations are inconclusive. SPECT/CT enables the simultaneous delineation of inflammatory and ischemic etiologies, directly guiding therapeutic decision-making, including bisphosphonate therapy and joint-protective rehabilitation. Conclusion: Three-phase 99mTc-MDP bone scintigraphy with SPECT/CT serves as a crucial imaging modality in evaluating complex polyarthralgia. These findings enabled timely therapeutic intervention, including reassessment of corticosteroid use, institution of bisphosphonate therapy (zoledronic acid), and joint-protective rehabilitation, illustrating the direct clinical impact of advanced nuclear medicine imaging. The persistence of symptoms despite treatment highlights the refractory nature of multifocal corticosteroid-induced AVN and the need for continued multidisciplinary follow-up.

Background: Conventional screening methods for cervical cancer, such as visual inspection with acetic acid (VIA), have limited specificity. The Swede score, a structured colposcopic scoring system, may improve detection and triage of cervical intraepithelial neoplasia (CIN) in VIA-positive women. Methods: This cross-sectional study was conducted in the Department of Obstetrics and Gynecology at a tertiary-level hospital in Bangladesh from October 2023 to July 2024. A total of 60 VIA-positive women meeting the selection criteria were consecutively enrolled after providing informed consent. Socio-demographic information and detailed medical history were recorded. All participants underwent colposcopic assessment using the Swede score, followed by colposcopy-guided biopsy. Data were analyzed using Stata (version 17). Results: The mean age was 41.7 ± 8.1 years, with 41.7% aged 40-49 and 48.3% having below-secondary education. Chronic cervicitis was found in 50%, while 30% had CIN1 and 18.3% had CIN2+. The mean Swede score was 5.3 ± 2.0. Notably, 96.6% of women with abnormal histopathology had Swede scores of 5-10, while 61.3% of those with normal histology scored 0-4. A Swede score cut-off of 6 demonstrated high sensitivity (82.8%) and specificity (96.8%) for CIN1+ (PPV 96.0%, NPV 85.7%). For CIN2+, a cut-off of 7 achieved perfect sensitivity (100%) and high specificity (85.7%), with an NPV of 100%. Multivariate analysis showed that each unit increase in Swede score increased the risk of CIN by 39-fold (AOR: 39.14, 95% CI: 2.33-658.33). Conclusion: The Swede score is a reliable tool for detecting CIN among VIA-positive women, supporting its use for targeted biopsies and "see-and-treat" strategies in low-resource settings.

Background: Colorectal cancer liver metastases (CRLM) remain a major therapeutic challenge with limited curative options. Radiofrequency ablation (RFA) has emerged as a potential adjunct to systemic therapy, but its survival benefit remains uncertain. Methods: This systematic review and meta-analysis was conducted according to PRISMA guidelines. PubMed, the Cochrane Library, ScienceDirect, and Embase were searched through 16 June 2025. Data were analyzed using RevMan version 5.4. Hazard ratios (HRs) were pooled for overall survival (OS) and progression-free survival (PFS), and risk ratios (RRs) were calculated for binary outcomes, each with 95% confidence intervals (CIs). Risk of bias was assessed using RoB 2 and ROBINS-I. Results: Out of 4625 records screened, three studies comprising 614 patients met the inclusion criteria. Pooled analysis demonstrated that RFA combined with systemic therapy significantly improved OS (HR = 0.46, 95% CI: 0.36–0.60, P < 0.001) and PFS (HR = 0.37, 95% CI: 0.20–0.67, P < 0.001) compared with systemic therapy alone. Secondary endpoints showed lower mortality (RR = 0.67, 95% CI: 0.59–0.76, P < 0.001) and reduced disease progression (RR = 0.92, 95% CI: 0.87–0.98, P = 0.005) in the RFA group. Conclusions: RFA combined with systemic therapy is associated with improved OS and PFS, with a trend toward reduced mortality and disease progression compared with systemic therapy alone among patients with unresectable colorectal liver metastases. These findings suggest a potential role for RFA in multimodal treatment; however, they should be interpreted cautiously given the limited and heterogeneous evidence base.