Please use this identifier to cite or link to this item:
https://hdl.handle.net/2440/10555
Citations | ||
Scopus | Web of Science® | Altmetric |
---|---|---|
?
|
?
|
Type: | Journal article |
Title: | Systematic review of the safety and effectiveness of methods used to establish pneumoperitoneum in laparoscopic surgery |
Author: | Merlin, T. Hiller, J. Maddern, G. Jamieson, G. Brown, A. Kolbe, A. |
Citation: | British Journal of Surgery, 2003; 90(6):668-679 |
Publisher: | John Wiley & Sons Ltd |
Issue Date: | 2003 |
ISSN: | 0007-1323 1365-2168 |
Statement of Responsibility: | T.L. Merlin, J.E. Hiller, G.J. Maddern, G.G. Jamieson, A.R. Brown and A. Kolbe |
Abstract: | <h4>Background</h4>A systematic review was conducted to determine which of the methods of obtaining peritoneal access and establishing pneumoperitoneum is the safest and most effective.<h4>Methods</h4>Studies that met the inclusion criteria were identified from six bibliographic databases up to May 2002, the internet, hand-searches and reference lists. They were critically appraised using a validated checklist and data were extracted using standardized protocols.<h4>Results</h4>Meta-analysis of prospective, non-randomized studies of open versus closed (needle/trocar) access indicated a trend during open access towards a reduced risk of major complications (pooled relative risk (RR(p)) 0.30, 95 per cent confidence interval (c.i.) 0.09 to 1.03). Open access was also associated with a trend towards a reduced risk of access-site herniation (RR(p) 0.21, 95 per cent c.i. 0.04 to 1.03) and, in non-obese patients, a 57 per cent reduced risk of minor complications (RR(p) 0.43, 95 per cent c.i. 0.20 to 0.92) and a trend for fewer conversions to laparotomy (RR(p) 0.21, 95 per cent c.i. 0.04 to 1.17). Data on major complications in studies of direct trocar versus needle/trocar access were inconclusive. Minor complications in randomized controlled trials were fewer with direct trocar access (RR(p) 0.19, 95 per cent c.i. 0.09 to 0.40), predominantly owing to a reduction in extraperitoneal insufflation.<h4>Conclusion</h4>The evidence on the comparative safety and effectiveness of the different access methods was not definitive, but there were trends in the data that merit further exploration. |
Keywords: | Humans Laparoscopy Pneumoperitoneum, Artificial Treatment Outcome Safety Randomized Controlled Trials as Topic Controlled Clinical Trials as Topic |
Description: | Copyright © 2003 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. The definitive version may be found at www.wiley.com |
DOI: | 10.1002/bjs.4203 |
Published version: | http://dx.doi.org/10.1002/bjs.4203 |
Appears in Collections: | Aurora harvest 2 Surgery publications |
Files in This Item:
There are no files associated with this item.
Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.