Cochrane · systematic review · CD009277
Laparoscopic versus open resection for sigmoid diverticulitis
Abraha, I, Binda, GA, Montedori, A, et al. · Cochrane Database of Systematic Reviews · 2017 · 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
18
current version
GRADE rated
18
No studies
0
Included studies
NR
No studies 0 · 0%Ungraded 0 · 0%Very low 11 · 61.1%Low 7 · 38.9%Moderate 0 · 0%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 vs open surgery for acute sigmoid diverticulitis
Population: patients with sigmoid diverticulitis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Mean hospital stay Laparoscopic vs open surgery | no estimate extracted | 3 studies · 360 participants | Low Downgraded: risk of bias, imprecision |
30‐Day postoperative mortality Laparoscopic vs open surgery | RR 0.24 [0.03, 2.07] | 3 studies · 360 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Overall surgical complications ( Laparoscopic vs open surgery | RR 0.84 [0.6, 1.19] | 3 studies · 360 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Early overall morbidity (30 postoperative days) Laparoscopic vs open surgery | RR 1.46 [0.51, 4.2] | 1 study · 113 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Late overall morbidity (after the first 30 postoperative days: within 6 months) Laparoscopic vs open surgery | RR 0.6 [0.26, 1.38] | 1 study · 93 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Late overall mortality (after the first 30 postoperative days) Laparoscopic vs open surgery | RR 2.04 [0.19, 21.77] | 1 study · 93 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Major complications ( Laparoscopic vs open surgery | RR 0.74 [0.43, 1.25] | 3 studies · 360 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Minor complications ( Laparoscopic vs open surgery | no estimate extracted | 3 studies · 360 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Operative time (minutes) Laparoscopic vs open surgery | no estimate extracted | 3 studies · 360 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Intraoperative blood loss (mL) Laparoscopic vs open surgery | no estimate extracted | 1 study · 104 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Postoperative pain (at day 4) Laparoscopic vs open surgery | no estimate extracted | 2 studies · 250 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Postoperative time to liquid diets (days) Laparoscopic vs open surgery | no estimate extracted | 2 studies · 247 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Postoperative time to solid diets (days) Laparoscopic vs open surgery | no estimate extracted | 2 studies · 247 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Reoperation rate due to anastomotic leak ( Laparoscopic vs open surgery | RR 0.75 [0.29, 1.95] | 3 studies · 349 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Anastomotic stricture ( Laparoscopic vs open surgery | RR 1 [0.06, 15.57] | 1 study · 104 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Small‐bowel obstruction ( Laparoscopic vs open surgery | RR 0.25 [0.03, 2.16] | 1 study · 104 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Quality of life Scales used: (1) SF‐36 questionnaire; (2) Gastrointestinal Quality of Life Index score; (3) EORTC QLQ‐C30 ( Laparoscopic vs open surgery | no estimate extracted | 2011 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Recurrent diverticulitis rate ( Laparoscopic vs open surgery | no estimate extracted | 2010 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |