Systematic review of the safety and effectiveness of methods used to establish pneumoperitoneum in laparoscopic surgery

Background: A systematic review was conducted to determine which of the methods of obtaining peritoneal access and establishing pneumoperitoneum is the safest and most effective. Methods: Studies that met the inclusion criteria were identified from six bibliographic databases up to May 2002, the int...

Ausführliche Beschreibung

Gespeichert in:
Bibliographische Detailangaben
Veröffentlicht in:British journal of surgery 2003-06, Vol.90 (6), p.668-679
Hauptverfasser: Merlin, T. L., Hiller, J. E., Maddern, G. J., Jamieson, G. G., Brown, A. R., Kolbe, A.
Format: Artikel
Sprache:eng
Schlagworte:
Online-Zugang:Volltext
Tags: Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
container_end_page 679
container_issue 6
container_start_page 668
container_title British journal of surgery
container_volume 90
creator Merlin, T. L.
Hiller, J. E.
Maddern, G. J.
Jamieson, G. G.
Brown, A. R.
Kolbe, A.
description Background: A systematic review was conducted to determine which of the methods of obtaining peritoneal access and establishing pneumoperitoneum is the safest and most effective. Methods: Studies that met the inclusion criteria were identified from six bibliographic databases up to May 2002, the internet, hand‐searches and reference lists. They were critically appraised using a validated checklist and data were extracted using standardized protocols. Results: Meta‐analysis of prospective, non‐randomized studies of open versus closed (needle/trocar) access indicated a trend during open access towards a reduced risk of major complications (pooled relative risk (RRp) 0·30, 95 per cent confidence interval (c.i.) 0·09 to 1·03). Open access was also associated with a trend towards a reduced risk of access‐site herniation (RRp 0·21, 95 per cent c.i. 0·04 to 1·03) and, in non‐obese patients, a 57 per cent reduced risk of minor complications (RRp 0·43, 95 per cent c.i. 0·20 to 0·92) and a trend for fewer conversions to laparotomy (RRp 0·21, 95 per cent c.i. 0·04 to 1·17). Data on major complications in studies of direct trocar versus needle/trocar access were inconclusive. Minor complications in randomized controlled trials were fewer with direct trocar access (RRp 0·19, 95 per cent c.i. 0·09 to 0·40), predominantly owing to a reduction in extraperitoneal insufflation. Conclusion: The evidence on the comparative safety and effectiveness of the different access methods was not definitive, but there were trends in the data that merit further exploration. Copyright © 2003 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. Evidence not definitive due to low overall complication rate
doi_str_mv 10.1002/bjs.4203
format Article
fullrecord <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_proquest_miscellaneous_73429516</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>73429516</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3523-5a650232bf26e6c898658597e200aa2089997f1bcff3ca8a8e56b321231e61133</originalsourceid><addsrcrecordid>eNpF0U1v1DAQBmALgehSkPgFyBe4pfhj7ThHqGj5KHDYIlAvluMdsy5JHDxJl_x7EnVhT2NpHnlG8xLynLMzzph4Xd_i2Vow-YCsuNSqEFybh2TFGCsLLoU8IU8QbxnjkinxmJxwYZjRXK7IfjPhAK0boqcZ7iLsaQp02AFFF2CYqOu2FEIAP8Q76ABx6bcw7NIW6YiwpUOigIOrm4g72ncwtqmHHIe0PGnsaON6lxP61M9DcMw_IU9PyaPgGoRnh3pKvl28uz5_X1x9vfxw_uaq8FIJWSinFRNS1EFo0N5URiujqhIEY84JZqqqKgOvfQjSO-MMKF1LwYXkoDmX8pS8uv-3z-n3OO9p24gemsZ1kEa0pVyLSnE9wxcHONYtbG2fY-vyZP-dagYvD8Chd03IrvMRj25tKiE0m11x7_axgenYZ3aJys5R2SUq-_bjZqlHH-cg_vz3Lv-yupSlst-_XNqbH58-34jNhb2WfwFiS5YK</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>73429516</pqid></control><display><type>article</type><title>Systematic review of the safety and effectiveness of methods used to establish pneumoperitoneum in laparoscopic surgery</title><source>MEDLINE</source><source>Oxford Journals (Firm)</source><source>Wiley Online Library (Online service)</source><creator>Merlin, T. L. ; Hiller, J. E. ; Maddern, G. J. ; Jamieson, G. G. ; Brown, A. R. ; Kolbe, A.</creator><creatorcontrib>Merlin, T. L. ; Hiller, J. E. ; Maddern, G. J. ; Jamieson, G. G. ; Brown, A. R. ; Kolbe, A.</creatorcontrib><description>Background: A systematic review was conducted to determine which of the methods of obtaining peritoneal access and establishing pneumoperitoneum is the safest and most effective. Methods: Studies that met the inclusion criteria were identified from six bibliographic databases up to May 2002, the internet, hand‐searches and reference lists. They were critically appraised using a validated checklist and data were extracted using standardized protocols. Results: Meta‐analysis of prospective, non‐randomized studies of open versus closed (needle/trocar) access indicated a trend during open access towards a reduced risk of major complications (pooled relative risk (RRp) 0·30, 95 per cent confidence interval (c.i.) 0·09 to 1·03). Open access was also associated with a trend towards a reduced risk of access‐site herniation (RRp 0·21, 95 per cent c.i. 0·04 to 1·03) and, in non‐obese patients, a 57 per cent reduced risk of minor complications (RRp 0·43, 95 per cent c.i. 0·20 to 0·92) and a trend for fewer conversions to laparotomy (RRp 0·21, 95 per cent c.i. 0·04 to 1·17). Data on major complications in studies of direct trocar versus needle/trocar access were inconclusive. Minor complications in randomized controlled trials were fewer with direct trocar access (RRp 0·19, 95 per cent c.i. 0·09 to 0·40), predominantly owing to a reduction in extraperitoneal insufflation. Conclusion: The evidence on the comparative safety and effectiveness of the different access methods was not definitive, but there were trends in the data that merit further exploration. Copyright © 2003 British Journal of Surgery Society Ltd. Published by John Wiley &amp; Sons, Ltd. Evidence not definitive due to low overall complication rate</description><identifier>ISSN: 0007-1323</identifier><identifier>EISSN: 1365-2168</identifier><identifier>DOI: 10.1002/bjs.4203</identifier><identifier>PMID: 12808613</identifier><identifier>CODEN: BJSUAM</identifier><language>eng</language><publisher>Chichester, UK: John Wiley &amp; Sons, Ltd</publisher><subject>Abdomen ; Biological and medical sciences ; Controlled Clinical Trials as Topic ; Humans ; Laparoscopy - methods ; Medical sciences ; Pneumoperitoneum, Artificial - adverse effects ; Pneumoperitoneum, Artificial - methods ; Pneumoperitoneum, Artificial - standards ; Randomized Controlled Trials as Topic ; Safety ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Surgery of the digestive system ; Treatment Outcome</subject><ispartof>British journal of surgery, 2003-06, Vol.90 (6), p.668-679</ispartof><rights>Copyright © 2003 British Journal of Surgery Society Ltd. Published by John Wiley &amp; Sons, Ltd.</rights><rights>2003 INIST-CNRS</rights><rights>Copyright 2003 British Journal of Surgery Society Ltd. Published by John Wiley &amp; Sons, Ltd.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3523-5a650232bf26e6c898658597e200aa2089997f1bcff3ca8a8e56b321231e61133</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fbjs.4203$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fbjs.4203$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&amp;idt=14892260$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/12808613$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Merlin, T. L.</creatorcontrib><creatorcontrib>Hiller, J. E.</creatorcontrib><creatorcontrib>Maddern, G. J.</creatorcontrib><creatorcontrib>Jamieson, G. G.</creatorcontrib><creatorcontrib>Brown, A. R.</creatorcontrib><creatorcontrib>Kolbe, A.</creatorcontrib><title>Systematic review of the safety and effectiveness of methods used to establish pneumoperitoneum in laparoscopic surgery</title><title>British journal of surgery</title><addtitle>Br J Surg</addtitle><description>Background: A systematic review was conducted to determine which of the methods of obtaining peritoneal access and establishing pneumoperitoneum is the safest and most effective. Methods: Studies that met the inclusion criteria were identified from six bibliographic databases up to May 2002, the internet, hand‐searches and reference lists. They were critically appraised using a validated checklist and data were extracted using standardized protocols. Results: Meta‐analysis of prospective, non‐randomized studies of open versus closed (needle/trocar) access indicated a trend during open access towards a reduced risk of major complications (pooled relative risk (RRp) 0·30, 95 per cent confidence interval (c.i.) 0·09 to 1·03). Open access was also associated with a trend towards a reduced risk of access‐site herniation (RRp 0·21, 95 per cent c.i. 0·04 to 1·03) and, in non‐obese patients, a 57 per cent reduced risk of minor complications (RRp 0·43, 95 per cent c.i. 0·20 to 0·92) and a trend for fewer conversions to laparotomy (RRp 0·21, 95 per cent c.i. 0·04 to 1·17). Data on major complications in studies of direct trocar versus needle/trocar access were inconclusive. Minor complications in randomized controlled trials were fewer with direct trocar access (RRp 0·19, 95 per cent c.i. 0·09 to 0·40), predominantly owing to a reduction in extraperitoneal insufflation. Conclusion: The evidence on the comparative safety and effectiveness of the different access methods was not definitive, but there were trends in the data that merit further exploration. Copyright © 2003 British Journal of Surgery Society Ltd. Published by John Wiley &amp; Sons, Ltd. Evidence not definitive due to low overall complication rate</description><subject>Abdomen</subject><subject>Biological and medical sciences</subject><subject>Controlled Clinical Trials as Topic</subject><subject>Humans</subject><subject>Laparoscopy - methods</subject><subject>Medical sciences</subject><subject>Pneumoperitoneum, Artificial - adverse effects</subject><subject>Pneumoperitoneum, Artificial - methods</subject><subject>Pneumoperitoneum, Artificial - standards</subject><subject>Randomized Controlled Trials as Topic</subject><subject>Safety</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</subject><subject>Surgery of the digestive system</subject><subject>Treatment Outcome</subject><issn>0007-1323</issn><issn>1365-2168</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2003</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpF0U1v1DAQBmALgehSkPgFyBe4pfhj7ThHqGj5KHDYIlAvluMdsy5JHDxJl_x7EnVhT2NpHnlG8xLynLMzzph4Xd_i2Vow-YCsuNSqEFybh2TFGCsLLoU8IU8QbxnjkinxmJxwYZjRXK7IfjPhAK0boqcZ7iLsaQp02AFFF2CYqOu2FEIAP8Q76ABx6bcw7NIW6YiwpUOigIOrm4g72ncwtqmHHIe0PGnsaON6lxP61M9DcMw_IU9PyaPgGoRnh3pKvl28uz5_X1x9vfxw_uaq8FIJWSinFRNS1EFo0N5URiujqhIEY84JZqqqKgOvfQjSO-MMKF1LwYXkoDmX8pS8uv-3z-n3OO9p24gemsZ1kEa0pVyLSnE9wxcHONYtbG2fY-vyZP-dagYvD8Chd03IrvMRj25tKiE0m11x7_axgenYZ3aJys5R2SUq-_bjZqlHH-cg_vz3Lv-yupSlst-_XNqbH58-34jNhb2WfwFiS5YK</recordid><startdate>200306</startdate><enddate>200306</enddate><creator>Merlin, T. L.</creator><creator>Hiller, J. E.</creator><creator>Maddern, G. J.</creator><creator>Jamieson, G. G.</creator><creator>Brown, A. R.</creator><creator>Kolbe, A.</creator><general>John Wiley &amp; Sons, Ltd</general><general>Wiley</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>7X8</scope></search><sort><creationdate>200306</creationdate><title>Systematic review of the safety and effectiveness of methods used to establish pneumoperitoneum in laparoscopic surgery</title><author>Merlin, T. L. ; Hiller, J. E. ; Maddern, G. J. ; Jamieson, G. G. ; Brown, A. R. ; Kolbe, A.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3523-5a650232bf26e6c898658597e200aa2089997f1bcff3ca8a8e56b321231e61133</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2003</creationdate><topic>Abdomen</topic><topic>Biological and medical sciences</topic><topic>Controlled Clinical Trials as Topic</topic><topic>Humans</topic><topic>Laparoscopy - methods</topic><topic>Medical sciences</topic><topic>Pneumoperitoneum, Artificial - adverse effects</topic><topic>Pneumoperitoneum, Artificial - methods</topic><topic>Pneumoperitoneum, Artificial - standards</topic><topic>Randomized Controlled Trials as Topic</topic><topic>Safety</topic><topic>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</topic><topic>Surgery of the digestive system</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Merlin, T. L.</creatorcontrib><creatorcontrib>Hiller, J. E.</creatorcontrib><creatorcontrib>Maddern, G. J.</creatorcontrib><creatorcontrib>Jamieson, G. G.</creatorcontrib><creatorcontrib>Brown, A. R.</creatorcontrib><creatorcontrib>Kolbe, A.</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>MEDLINE - Academic</collection><jtitle>British journal of surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Merlin, T. L.</au><au>Hiller, J. E.</au><au>Maddern, G. J.</au><au>Jamieson, G. G.</au><au>Brown, A. R.</au><au>Kolbe, A.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Systematic review of the safety and effectiveness of methods used to establish pneumoperitoneum in laparoscopic surgery</atitle><jtitle>British journal of surgery</jtitle><addtitle>Br J Surg</addtitle><date>2003-06</date><risdate>2003</risdate><volume>90</volume><issue>6</issue><spage>668</spage><epage>679</epage><pages>668-679</pages><issn>0007-1323</issn><eissn>1365-2168</eissn><coden>BJSUAM</coden><abstract>Background: A systematic review was conducted to determine which of the methods of obtaining peritoneal access and establishing pneumoperitoneum is the safest and most effective. Methods: Studies that met the inclusion criteria were identified from six bibliographic databases up to May 2002, the internet, hand‐searches and reference lists. They were critically appraised using a validated checklist and data were extracted using standardized protocols. Results: Meta‐analysis of prospective, non‐randomized studies of open versus closed (needle/trocar) access indicated a trend during open access towards a reduced risk of major complications (pooled relative risk (RRp) 0·30, 95 per cent confidence interval (c.i.) 0·09 to 1·03). Open access was also associated with a trend towards a reduced risk of access‐site herniation (RRp 0·21, 95 per cent c.i. 0·04 to 1·03) and, in non‐obese patients, a 57 per cent reduced risk of minor complications (RRp 0·43, 95 per cent c.i. 0·20 to 0·92) and a trend for fewer conversions to laparotomy (RRp 0·21, 95 per cent c.i. 0·04 to 1·17). Data on major complications in studies of direct trocar versus needle/trocar access were inconclusive. Minor complications in randomized controlled trials were fewer with direct trocar access (RRp 0·19, 95 per cent c.i. 0·09 to 0·40), predominantly owing to a reduction in extraperitoneal insufflation. Conclusion: The evidence on the comparative safety and effectiveness of the different access methods was not definitive, but there were trends in the data that merit further exploration. Copyright © 2003 British Journal of Surgery Society Ltd. Published by John Wiley &amp; Sons, Ltd. Evidence not definitive due to low overall complication rate</abstract><cop>Chichester, UK</cop><pub>John Wiley &amp; Sons, Ltd</pub><pmid>12808613</pmid><doi>10.1002/bjs.4203</doi><tpages>12</tpages></addata></record>
fulltext fulltext
identifier ISSN: 0007-1323
ispartof British journal of surgery, 2003-06, Vol.90 (6), p.668-679
issn 0007-1323
1365-2168
language eng
recordid cdi_proquest_miscellaneous_73429516
source MEDLINE; Oxford Journals (Firm); Wiley Online Library (Online service)
subjects Abdomen
Biological and medical sciences
Controlled Clinical Trials as Topic
Humans
Laparoscopy - methods
Medical sciences
Pneumoperitoneum, Artificial - adverse effects
Pneumoperitoneum, Artificial - methods
Pneumoperitoneum, Artificial - standards
Randomized Controlled Trials as Topic
Safety
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Surgery of the digestive system
Treatment Outcome
title Systematic review of the safety and effectiveness of methods used to establish pneumoperitoneum in laparoscopic surgery
url https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-25T05%3A19%3A53IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Systematic%20review%20of%20the%20safety%20and%20effectiveness%20of%20methods%20used%20to%20establish%20pneumoperitoneum%20in%20laparoscopic%20surgery&rft.jtitle=British%20journal%20of%20surgery&rft.au=Merlin,%20T.%20L.&rft.date=2003-06&rft.volume=90&rft.issue=6&rft.spage=668&rft.epage=679&rft.pages=668-679&rft.issn=0007-1323&rft.eissn=1365-2168&rft.coden=BJSUAM&rft_id=info:doi/10.1002/bjs.4203&rft_dat=%3Cproquest_pubme%3E73429516%3C/proquest_pubme%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=73429516&rft_id=info:pmid/12808613&rfr_iscdi=true