Laparoscopic versus open appendectomy in adults and children: A meta-analysis of randomized controlled trials
Laparoscopic versus open appendectomy in adults and children: A meta-analysis of randomized controlled trials
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DOI：
10.1177/2050640616661931
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发表时间：
2017-06-01
影响因子：
6
通讯作者：
Shuai, Jian
中科院分区：
文献类型：
--
作者：
Dai, Liping;Shuai, Jian
目的：比较腹腔镜阑尾切除术(LA)和开腹阑尾切除术(OA)在成人和儿童中的差异。方法：本研究纳入1992年1月至2016年3月在成人和儿童中比较LA和OA的随机对照试验。对伤口感染、腹内脓肿、术后并发症、再手术率、手术时间、术后停留时间和恢复正常活动情况进行Meta分析。结果：共纳入33项研究，3642例患者(LA 1810例，OA 1832例)。与OA组相比，成人LA组伤口感染发生率低，术后并发症少，术后住院时间短，恢复正常活动时间早，但手术时间长。两组间的腹内脓肿和再手术水平无差异。儿童组亚组分析未发现两种术式在伤口感染、术后并发症、术后住院时间、恢复正常活动等方面差异有统计学意义。结论：成人腹腔镜术是一种安全有效的治疗急性阑尾炎的术式，还需在儿童中进行高质量的随机对照试验。
Objective: The aim of this study was to evaluate the differences of laparoscopic appendectomy (LA) versus open appendectomy (OA) in adults and children.Methods: Randomized controlled trials (RCTs) comparing LA and OA in adults and children between January 1992-March 2016 were included in this study. A meta-analysis was performed to evaluate wound infection, intra-abdominal abscess, postoperative complications, reoperation rate, operation time, postoperative stay, and return to normal activity.Result: Thirty-three studies including 3642 patients (1810 LA, 1832 OA) were included. Compared with OA, LA in adults was associated with lower incidence of wound infection, fewer postoperative complications, shorter postoperative stay, and earlier return to normal activity, but a longer operation time. There was no difference in levels of intra-abdominal abscess and reoperation between the groups. Subgroup analysis in children did not reveal significant differences between the two techniques in wound infection, postoperative complications, postoperative stay, and return to normal activity.Conclusion: LA in adults is worth recommending as an effective and safe procedure for acute appendicitis, and further high-quality randomized trials comparing the two techniques in children are needed.