Peritoneal irrigation vs suction alone during pediatric appendectomy for perforated appendicitis: A meta-analysis
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Published on: November 12, 2021
Le-Wee Bi1, Bei-Lei Yan1, Qian-Yu Yang1
1Department of the Graduate School, Tianjin Medical University.
Insights
Peritoneal irrigation during pediatric appendectomy did not reduce intra-abdominal abscess rates. This meta-analysis found no significant difference in abscess or wound infection incidence between irrigation and suction groups.
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.
Background:
There currently exists no substantial evidence reporting the efficacy of peritoneal irrigation in reducing the incidence of postoperative intra-abdominal abscess in pediatric patients. The purpose of our study was to perform a meta-analysis to compare rates of intra-abdominal abscess after appendectomy between irrigation and suction alone groups.
Methods:
We identified studies by a systematic search in EMBASE, PubMed, Web of Science, and the Cochrane Library to recognize randomized controlled trials and case control studies from the 1950 to May 2019. We limited the English language studies. We checked the reference list of studies to recognize other potentially qualified trials. We analyzed the merged data with use of the Review Manager 5.3.
Results:
We identified 6 eligible papers enrolling a total of 1633 participants. We found no significant difference in the incidence of postoperative intraabdominal abscess, wound infection, and the length of hospitalization between 2 group, but duration of surgery is longer in irrigation group (MD = 6.76, 95% CI = 4.64 to 8.87, P < .001; heterogeneity, I = 25%, P = .26).
Conclusion:
Our meta-analysis did not provide strong evidence allowing definite conclusions to be drawn, but suggested that peritoneal irrigation during appendectomy did not decrease the incidence of postoperative IAA. This meta-analysis also indicated the need for more high-quality trials to identify methods to decrease the incidence of postoperative IAA in pediatric perforated appendicitis patients.Trial registration number Standardization of endoscopic treatment of acute abdomen in children: 14RCGFSY00150.
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