Cochrane · systematic review · CD001546
Laparoscopic versus open surgery for suspected appendicitis
Jaschinski, T, Mosch, CG, Eikermann, M, et al. · Cochrane Database of Systematic Reviews · 2018 · Cochrane Library
ColorectalAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
24
current version
GRADE rated
21
No studies
3
Included studies
NR
No studies 3 · 12.5%Ungraded 0 · 0%Very low 2 · 8.3%Low 12 · 50%Moderate 7 · 29.2%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Laparoscopic versus open appendectomy in adults or adolescents for suspected appendicitis
Population: patients with suspected appendicitis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Pain intensity on day 1 Laparoscopic vs open appendectomy | no estimate extracted | 20 studies · 2421 participants | Low Downgraded: risk of bias, inconsistency |
Wound infections Laparoscopic vs open appendectomy | Peto OR 0.42 [0.35, 0.51] | 63 studies · 7612 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency |
Intra‐abdominal abscesses Laparoscopic vs open appendectomy | Peto OR 1.65 [1.12, 2.43] | 53 studies · 6677 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency |
Length of hospital stay (days) Laparoscopic vs open appendectomy | no estimate extracted | 46 studies · 5127 participants | Low Downgraded: risk of bias, inconsistency |
Time until return to normal activities (days) Laparoscopic vs open appendectomy | no estimate extracted | 17 studies · 1653 participants | Low Downgraded: risk of bias, inconsistency |
Quality of life Scale used: 1) Gastro‐intestinal Quality of Life Index 2) SF‐36 questionnaire Laparoscopic vs open appendectomy | 2 | 2009 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Laparoscopic versus open appendectomy in children for suspected appendicitis
Population: patients with suspected appendicitis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Pain intensity on day Laparoscopic vs open appendectomy | no estimate extracted | 1 study · 61 participants | Low Downgraded: risk of bias, imprecision |
Wound infections (rate) Laparoscopic vs open appendectomy | Peto OR 0.25 [0.15, 0.42] | 10 studies · 1245 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency |
Intra‐abdominal abscesses (rate) Laparoscopic vs open appendectomy | Peto OR 0.54 [0.24, 1.22] | 9 studies · 1185 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Length of hospital stay (days) Laparoscopic vs open appendectomy | no estimate extracted | 6 studies · 316 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Time until return to normal activities (days) Laparoscopic vs open appendectomy | no estimate extracted | 1 study · 383 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency |
Quality of life Laparoscopic vs open appendectomy | no estimate extracted | NR | No studies |
Subgroup analysis (publication date) ‐ Laparoscopic versus open appendectomy in adults or adolescents for suspected appendicitis
Population: patients with suspected appendicitis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Pain intensity on day 1 Subgroup analysis (publication date) ‐ Laparoscopic vs open appendectomy | no estimate extracted | 7 studies · 613 participants | Low Downgraded: risk of bias, inconsistency |
Wound infections Subgroup analysis (publication date) ‐ Laparoscopic vs open appendectomy | Peto OR 0.37 [0.27, 0.51] | 19 studies · 2217 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency |
Intra‐abdominal abscesses Subgroup analysis (publication date) ‐ Laparoscopic vs open appendectomy | Peto OR 0.82 [0.44, 1.51] | 11 studies · 1466 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Length of hospital stay Subgroup analysis (publication date) ‐ Laparoscopic vs open appendectomy | no estimate extracted | 17 studies · 1977 participants | Low Downgraded: risk of bias, inconsistency |
Time until return to normal activity Subgroup analysis (publication date) ‐ Laparoscopic vs open appendectomy | no estimate extracted | 3 studies · 380 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Quality of life Scale used: Gastro‐intestinal Quality of Life Index Subgroup analysis (publication date) ‐ Laparoscopic vs open appendectomy | no estimate extracted | 2009 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Subgroup analysis (publication date) ‐ Laparoscopic versus open appendectomy in children for suspected appendicitis
Population: patients with suspected appendicitis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Pain intensity on day 1 Subgroup analysis (publication date) ‐ Laparoscopic vs open appendectomy | no estimate extracted | NR | No studies |
Wound infections Subgroup analysis (publication date) ‐ Laparoscopic vs open appendectomy | Peto OR 0.27 [0.14, 0.52] | 5 studies · 783 participants | Moderate Downgraded: risk of bias |
Intra‐abdominal abscesses Subgroup analysis (publication date) ‐ Laparoscopic vs open appendectomy | Peto OR 0.45 [0.19, 1.07] | 4 studies · 723 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Length of hospital stay Subgroup analysis (publication date) ‐ Laparoscopic vs open appendectomy | no estimate extracted | 3 studies · 140 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Time until return to normal activity Subgroup analysis (publication date) ‐ Laparoscopic vs open appendectomy | no estimate extracted | 1 study · 383 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency |
Quality of life Subgroup analysis (publication date) ‐ Laparoscopic vs open appendectomy | no estimate extracted | NR | No studies |