Laparoscopic versus laparoscopy-assisted suturing of perforated peptic ulcers (meta-analysis)

OBJECTIVE: To compare laparoscopic and laparoscopy-assisted repair of perforated peptic ulcer using evidence-based methods.

MATERIAL AND METHODS: A systematic review and meta-analysis were carried out in accordance with the recommendations of the Ministry of Health of Russian Federation and Cochrane Handbook for Systematic Reviews.

Data searching was carried out in Russian and English languages using the E-library, Cochrane Library and PubMed databases. We analyzed titles and references in specialized journals and thematic reviews, respectively. Clarifying information was obtained via personal contacts with the heads of surgical hospitals. The RevMan 5.4 software was used for statistical analysis.

RESULTS: We found no randomized trials devoted to comparison of laparoscopic and laparoscopy-assisted surgeries in patients with perforated peptic ulcer. Meta-analysis was based on non-randomized trials with satisfactory methodological quality according to the I-ROBINS formalized assessment. Overall clinical material included 478 observations: 229 (47.9%) laparoscopic surgeries and 249 (52.1%) laparoscopy-assisted procedures via minimally invasive access. There were no conversions. Incidence of postoperative complications was 4.36 and 8.83% (OR=0.39, 95% CI 0.08, 1.87), postoperative mortality 0.87 and 0.81%, respectively (OR=1.26, 95% CI 0.08, 8.24). Laparoscopic surgeries were shorter (MD= -8 min, 95% CI -9.7, -6.4). Length of hospital-stay was also shorter after laparoscopic surgery (MD= -4.6, 95% CI -9.7, -6.4).

CONCLUSION: Laparoscopic operations are shorter and accompanied by lower incidence of postoperative complications and less hospital-stay. Large statistical power is required to confirm these differences.

Medienart:

E-Artikel

Erscheinungsjahr:

2023

Erschienen:

2023

Enthalten in:

Zur Gesamtaufnahme - year:2023

Enthalten in:

Khirurgiia - (2023), 2 vom: 07., Seite 72-78

Sprache:

Russisch

Weiterer Titel:

Laparoskopicheskoe i laparoskopicheski assistirovannoe ushivanie probodnoi yazvy (metaanaliz)

Beteiligte Personen:

Panin, S I [VerfasserIn]
Beburishvili, A G [VerfasserIn]
Fedorov, A V [VerfasserIn]
Sazhin, I V [VerfasserIn]
Mikhin, I V [VerfasserIn]
Nishnevich, E V [VerfasserIn]
Levchuk, A L [VerfasserIn]
Timerbulatov, Sh V [VerfasserIn]

Links:

Volltext

Themen:

English Abstract
Journal Article
Laparoscopy
Meta-Analysis
Meta-analysis
Perforated ulcer
Systematic Review

Anmerkungen:

Date Completed 09.02.2023

Date Revised 09.02.2023

published: Print

Citation Status MEDLINE

doi:

10.17116/hirurgia202302172

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM352588241