What do systematic reviews say?

Early enteral nutrition within 24 hours of lower gastrointestinal surgery vs later commencement

Early enteral nutrition within 24 hours of lower gastrointestinal… showed no clear difference in mortality compared with later commencement (low certainty).

• Early enteral nutrition within 24 hours of lower gastrointestinal surgery versus later commencement for length of… 2019 · Cochrane Headline outcomes only
  RR 0.56 [0.21, 1.52]
  12 studies · 1179 participants
  Low

Mesh vs non‐mesh repair

The review found no eligible studies for this question.

• Mesh versus non‐mesh for inguinal and femoral hernia repair 2018 · Cochrane Headline outcomes only
  no estimate extracted
  Studies not reported
  No studies found

Prehabilitation vs no prehabilitation

The review found no eligible studies for this question.

• Prehabilitation versus no prehabilitation to improve functional capacity, reduce postoperative complications and… 2023 · Cochrane Headline outcomes only
  no estimate extracted
  Studies not reported
  No studies found

Summary of findings table ‐ Combined mechanical and oral antibiotic bowel preparation vs no bowel preparation

Summary of findings table ‐ Combined mechanical and oral antibiotic… showed no clear difference in mortality compared with no bowel preparation (low certainty).

• Preoperative combined mechanical and oral antibiotic bowel preparation for preventing complications in elective… 2023 · Cochrane Headline outcomes only
  RR 0.2 [0.01, 4.22]
  1 study · 396 participants
  Low

Summary of findings table ‐ Combined mechanical and oral antibiotic bowel preparation vs mechanical bowel preparation alone

Summary of findings table ‐ Combined mechanical and oral antibiotic… showed no clear difference in mortality compared with mechanical bowel preparation alone (moderate certainty).

• Preoperative combined mechanical and oral antibiotic bowel preparation for preventing complications in elective… 2023 · Cochrane Headline outcomes only
  RR 0.87 [0.27, 2.82]
  3 studies · 639 participants
  Moderate

Summary of findings table ‐ Combined mechanical and oral antibiotic bowel preparation vs oral antibiotics

Summary of findings table ‐ Combined mechanical and oral antibiotic… showed no clear difference in mortality compared with oral antibiotics alone (low certainty).

• Preoperative combined mechanical and oral antibiotic bowel preparation for preventing complications in elective… 2023 · Cochrane Headline outcomes only
  RR 1.02 [0.3, 3.5]
  2 studies · 709 participants
  Low

Helium vs carbon dioxide

• Gases for establishing pneumoperitoneum during laparoscopic abdominal surgery 2022 · Cochrane Headline outcomes only
  no estimate extracted
  5 studies · 177 participants
  Very low

Room air vs carbon dioxide

• Gases for establishing pneumoperitoneum during laparoscopic abdominal surgery 2022 · Cochrane Headline outcomes only
  no estimate extracted
  1 study · 146 participants
  Very low

Nitrous oxide vs carbon dioxide

• Gases for establishing pneumoperitoneum during laparoscopic abdominal surgery 2022 · Cochrane Headline outcomes only
  no estimate extracted
  4 studies · 260 participants
  Very low

Intervention not reported

The intervention showed no clear difference in mortality (moderate certainty).

• Prolonged thromboprophylaxis with low molecular weight heparin for abdominal or pelvic surgery 2019 · Cochrane Headline outcomes only
  OR 1.15 [0.72, 1.84]
  7 studies · 1881 participants
  Moderate

Antibiotics vs surgery

It is very uncertain whether antibiotics changes mortality compared with surgery (very low certainty).

• Appendectomy versus antibiotic treatment for acute appendicitis 2024 · Cochrane Headline outcomes only
  OR 0.51 [0.05, 4.95]
  5 studies · 2377 participants
  Very low

Preoperative radiotherapy vs surgery

Preoperative radiotherapy probably leads to lower overall mortality ( compared with surgery alone (moderate certainty).

• Preoperative radiotherapy and curative surgery for the management of localised rectal carcinoma 2018 · Cochrane Headline outcomes only
  Peto OR 0.9 [0.83, 0.98]
  4 studies · 4663 participants
  Moderate

Primary analyses ERAS vs conventional

Primary analyses ERAS showed no clear difference in mortality outpatient compared with conventional (high certainty).

• Fast track surgery versus conventional recovery strategies for colorectal surgery 2011 · Cochrane Headline outcomes only
  RR 0.53 [0.12, 2.38]
  4 studies · 237 participants
  High

Preoperative radiotherapy vs surgery

Preoperative radiotherapy showed no clear difference in cause‐specific mortality ( compared with surgery alone (low certainty).

• Preoperative radiotherapy and curative surgery for the management of localised rectal carcinoma 2018 · Cochrane Headline outcomes only
  Peto OR 0.89 [0.77, 1.03]
  2 studies · 2145 participants
  Low

Intra‐abdominal drainage vs no drainage after pelvic lymphadenectomy

Intra‐abdominal drainage showed no clear difference in mortality compared with no drainage (low certainty).

• Intra‐abdominal drains for the prophylaxis of anastomotic leak in elective colorectal surgery 2004 · Cochrane Headline outcomes only
  RR 0.77 [0.41, 1.45]
  3 studies · 908 participants
  Low

Intervention not reported

It is very uncertain whether the intervention changes inpatient and 30 day mortality ‐ Colon cancer (very low certainty).

• Workload and surgeon´s specialty for outcome after colorectal cancer surgery 2012 · Cochrane Headline outcomes only
  OR 0.79 [0.61, 1.02]
  3 studies · 47584 participants
  Very low

Intervention not reported

It is very uncertain whether the intervention changes inpatient and 30 day mortality ‐ Colon cancer (very low certainty).

• Workload and surgeon´s specialty for outcome after colorectal cancer surgery 2012 · Cochrane Headline outcomes only
  OR 0.89 [0.78, 1.01]
  7 studies · 263071 participants
  Very low

Intervention not reported

The intervention showed no clear difference in inpatient and 30 day mortality ‐ Rectal cancer (low certainty).

• Workload and surgeon´s specialty for outcome after colorectal cancer surgery 2012 · Cochrane Headline outcomes only
  OR 0.79 [0.51, 1.22]
  1 study · 1903 participants
  Low

Intervention not reported

It is very uncertain whether the intervention changes inpatient and 30 day mortality ‐ Rectal cancer (very low certainty).

• Workload and surgeon´s specialty for outcome after colorectal cancer surgery 2012 · Cochrane Headline outcomes only
  OR 1.07 [0.76, 1.5]
  5 studies · 14941 participants
  Very low

Intervention not reported

The intervention may leads to lower inpatient and 30 day mortality ‐ Colorectal cancer (low certainty).

• Workload and surgeon´s specialty for outcome after colorectal cancer surgery 2012 · Cochrane Headline outcomes only
  OR 0.74 [0.6, 0.91]
  2 studies · 11973 participants
  Low