Aspiration versus peritoneal lavage in appendicitis: a meta-analysis.

Autor: Burini G; General and Emergency Surgical Clinic of Ancona, Ancona, Italy. globur@libero.it., Cianci MC; Department of Pediatric Surgery, Meyer Children's Hospital, University of Florence, Florence, Italy., Coccetta M; Hospital of Terni, Terni, Italy., Spizzirri A; Hospital of Terni, Terni, Italy., Di Saverio S; Department of Colorectal Surgery, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Hills Road, Cambridge, CB2 0QQ, UK., Coletta R; Department of Pediatric Surgery, Meyer Children's Hospital, School of Environment and Life Science, University of Salford, Salford, UK., Sapienza P; Department of Surgery, University of Rome, Sapienza, Italy., Mingoli A; Department of Surgery, University of Rome, Sapienza, Italy., Cirocchi R; Department of Medicine and Surgery, University of Perugia, Perugia, Italy., Morabito A; Department of Pediatric Surgery, Meyer Children's Hospital, Department of Neurofarba, University of Florence, Florence, Italy.
Jazyk: angličtina
Zdroj: World journal of emergency surgery : WJES [World J Emerg Surg] 2021 Sep 06; Vol. 16 (1), pp. 44. Date of Electronic Publication: 2021 Sep 06.
DOI: 10.1186/s13017-021-00391-y
Abstrakt: Background: Acute appendicitis is one of the most frequent abdominal surgical emergencies. Intra-abdominal abscess is a frequent post-operative complication. The aim of this meta-analysis was to compare peritoneal irrigation and suction versus suction only when performing appendectomy for complicated appendicitis.
Methods: According to PRISMA guidelines, a systematic review was conducted and registered into the Prospero register (CRD42020186848). The risk of bias was defined to be from low to moderate.
Results: Seventeen studies (9 RCTs and 8 CCTs) were selected, including 5315 patients. There was no statistical significance in post-operative intra-abdominal abscess in open (RR 1.27, 95% CI 0.75-2.15; I 2  = 74%) and laparoscopic group (RR 1.51, 95% CI 0.73-3.13; I 2  = 83%). No statistical significance in reoperation rate in open (RR 1.27, 95% CI 0.04-2.49; I 2  = 18%) and laparoscopic group (RR 1.42, 95% CI 0.64-2.49; I 2  = 18%). In both open and laparoscopic groups, operative time was lower in the suction group (RR 7.13, 95% CI 3.14-11.12); no statistical significance was found for hospital stay (MD - 0.39, 95% CI - 1.07 to 0.30; I 2  = 91%) and the rate of wound infection (MD 1.16, 95% CI 0.56-2.38; I 2  = 71%).
Conclusions: This systematic review has failed to demonstrate the statistical superiority of employing intra-operative peritoneal irrigation and suction over suction-only to reduce the rate of post-operative complications after appendectomy, but all the articles report clinical superiority in terms of post-operative abscess, wound infection and operative times in suction-only group.
(© 2021. The Author(s).)
Databáze: MEDLINE
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