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Meta-analysis of the clinical efficacy of laparoscopic appendectomy in the treatment of acute appendicitis
World Journal of Emergency Surgery ( IF 6.0 ) Pub Date : 2022-05-26 , DOI: 10.1186/s13017-022-00431-1
Guangzhe Zhang 1 , Bo Wu 1
Affiliation  

This paper compares the postoperative recovery of patients with acute appendicitis (AA) after laparoscopic appendectomy (LA) and open appendectomy (OA), aiming to determine the optimal diagnosis and treatment plan for appendectomy. Related literature was retrieved from PubMed, Web of Science, Embase, CNKI and Wanfang databases. Articles on LA and OA for AA published between 2010 and 2021 were selected to extract data. Besides, Stata16.0 was used for meta-analysis. A total of 777 articles were retrieved, and 16 of them were finally selected. Totally, 1251 patients underwent LA, while 898 patients received OA. According to the results of meta-analysis, LA was associated with lower incidence of adverse reactions [OR = 0.257, 95% CI (0.162, 0.408), P < 0.001], shorter operation time (SMD = − 1.802, 95% CI − 2.435, − 1.169; P < 0.001) and hospitalization (SMD = − 1.184, 95% CI − 1.512, − 0.856; P < 0.001). In addition, compared with the OA group, LA was found with less intraoperative blood loss (SMD = − 3.650, 95% CI − 5.088, − 2.212; P < 0.001) and shorter recovery time of gastrointestinal function (SMD = − 3.010, 95% CI − 3.816, − 2.203; P < 0.001). Aside from all these, the counts of leukocyte (SMD = − 0.432, 95% CI: − 0.775, − 0.089; P = 0.013), neutrophil (SMD = − 1.346, 95% CI − 2.560, − 0.133; P = 0.030), and C-reactive protein (SMD = − 2.391, 95% CI − 3.901, − 0.882; P = 0.002) all decreased in a significant manner after LA. Compared with OA, LA boasts the advantages of less adverse reactions, shorter operation time and hospitalization, fewer complications, and lower inflammatory response, evidencing its safety and feasibility of applying in the treatment of AA.

中文翻译:

腹腔镜阑尾切除术治疗急性阑尾炎临床疗效的Meta分析

本文比较急性阑尾炎(AA)患者在腹腔镜阑尾切除术(LA)和开腹阑尾切除术(OA)后的术后恢复情况,旨在确定阑尾切除术的最佳诊治方案。相关文献检索自 PubMed、Web of Science、Embase、CNKI 和万方数据库。选择 2010 年至 2021 年间发表的关于 AA 的 LA 和 OA 的文章来提取数据。此外,使用Stata16.0进行荟萃分析。共检索到777篇文章,最终选出16篇。共有 1251 名患者接受了 LA,而 898 名患者接受了 OA。根据荟萃分析的结果,LA 与较低的不良反应发生率相关[OR = 0.257, 95% CI (0.162, 0.408), P < 0.001],较短的手术时间 (SMD = - 1.802, 95% CI - 2.435,- 1.169;P < 0。001)和住院治疗(SMD = - 1.184, 95% CI - 1.512, - 0.856; P < 0.001)。此外,与 OA 组相比,LA 的术中失血量更少(SMD = - 3.650, 95% CI - 5.088, - 2.212; P < 0.001),胃肠功能恢复时间更短(SMD = - 3.010, 95 % CI - 3.816, - 2.203;P < 0.001)。除此之外,白细胞计数(SMD = - 0.432, 95% CI: - 0.775, - 0.089; P = 0.013),中性粒细胞(SMD = - 1.346, 95% CI - 2.560, - 0.133; P = 0.030)和 C 反应蛋白 (SMD = - 2.391, 95% CI - 3.901, - 0.882; P = 0.002) 在 LA 后均显着下降。与OA相比,LA具有不良反应少、手术时间和住院时间短、并发症少、炎症反应低等优点,
更新日期:2022-05-27
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