The evolution of laparoscopy in abdominal surgery: a meta-analysis of the effect on infectious outcomes.
Minim Invasive Ther Allied Technol
; 23(2): 74-86, 2014 Mar.
Article
em En
| MEDLINE
| ID: mdl-24236695
BACKGROUND: Laparoscopic surgery has been recommended as an effective strategy because of its advantages in decreasing abdominal surgical site infections (SSIs). The aim of this study was to assess the effect of laparoscopy on superficial and organ/space SSIs compared with open surgery in hollow-viscus procedures over time. STUDY DESIGN: Data on SSIs from randomized-controlled trials (RCTs) evaluating open versus laparoscopic abdominal surgeries were extracted from the Cochrane Database Reviews. Re-analysis of these data was performed to assess infections. Heterogeneity was also explored. A subgroup analysis was performed according to elective/emergency surgery status. RESULTS: Data from 72 RCTs including 8218 patients were collected (4116 patients in the laparoscopic group and 4102 patients in the open group). For superficial SSI, the pooled RD was -4.4% (95% CI: -5.4% to -3.3%), which indicated a lower risk in the laparoscopic group. For organ/space SSI, the pooled RD was 0.5% (95% CI: -0.1% to 1%), which indicated similar rates between the groups. Changes in SSI frequency had occurred over time. CONCLUSION: Laparoscopic surgery significantly decreases the risk of superficial SSI but does not affect the risk of organ/space SSI. Experience with technique improves outcomes.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Procedimentos Cirúrgicos do Sistema Digestório
/
Infecção da Ferida Cirúrgica
/
Laparoscopia
Tipo de estudo:
Clinical_trials
/
Etiology_studies
/
Risk_factors_studies
/
Systematic_reviews
Limite:
Humans
Idioma:
En
Revista:
Minim Invasive Ther Allied Technol
Assunto da revista:
TERAPEUTICA
Ano de publicação:
2014
Tipo de documento:
Article
País de afiliação:
Colômbia
País de publicação:
Reino Unido