Peritoneal irrigation vs suction alone during pediatric appendectomy for perforated appendicitis: A meta-analysis

Area of Science:

• Pediatric Surgery
• Gastrointestinal Surgery
• Evidence-Based Medicine

Background:

• Limited evidence exists on peritoneal irrigation's efficacy in preventing postoperative intra-abdominal abscess (IAA) in pediatric appendectomy patients.
• Appendectomy is a common pediatric surgical procedure, with IAA a potential complication.

Purpose of the Study:

• To conduct a meta-analysis comparing IAA rates after appendectomy between patients who received peritoneal irrigation and those treated with suction alone.
• To evaluate the effectiveness of peritoneal irrigation in reducing postoperative complications.

Main Methods:

• Systematic literature search of EMBASE, PubMed, Web of Science, and Cochrane Library for randomized controlled trials and case control studies (1950-May 2019).
• Inclusion of English language studies and reference list screening for additional trials.
• Data analysis using Review Manager 5.3.

Main Results:

• Six eligible studies with 1633 participants were included.
• No significant difference was found in the incidence of postoperative IAA, wound infection, or hospitalization length between the irrigation and suction groups.
• The duration of surgery was significantly longer in the irrigation group (MD = 6.76, P < .001).

Conclusions:

• The meta-analysis suggests that peritoneal irrigation during appendectomy does not decrease the incidence of postoperative IAA in pediatric patients.
• The current evidence is insufficient for definitive conclusions, highlighting the need for high-quality trials.
• Further research is required to identify effective methods for reducing postoperative IAA in pediatric perforated appendicitis.