Elective Open versus Laparoscopic Sigmoid Colectomy for Diverticular Disease: A Meta-Analysis with the Sigma Trial
Background A meta-analysis of published literature comparing open versus laparoscopic elective sigmoid resections for diverticular disease was conducted. Methods Electronic databases were searched for data from January 1991 to March 2009. A systematic review was performed to obtain a summative outco...
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| Veröffentlicht in: | World journal of surgery 2010-12, Vol.34 (12), p.2883-2901 |
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| creator | Siddiqui, Muhammed R. S. Sajid, Muhammed S. Khatri, Kamran Cheek, Elizabeth Baig, Mirza K. |
| description | Background
A meta-analysis of published literature comparing open versus laparoscopic elective sigmoid resections for diverticular disease was conducted.
Methods
Electronic databases were searched for data from January 1991 to March 2009. A systematic review was performed to obtain a summative outcome.
Results
Twenty-two comparative studies involving 10,898 patients were analyzed; 1538 patients were in the laparoscopic group and 9360 were in the open group. The operative time for laparoscopic sigmoid resection (LSR) is longer than open resections (OSR) [random-effects model: SMD = 1.94, 95% CI = (1.14, 2.74),
z
= 4.74,
p
|
| doi_str_mv | 10.1007/s00268-010-0762-3 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_808463519</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2193823171</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4502-f7a7e57822d608870006f599fdf6ecec0fdc530fb4c07d2de138455320c6192d3</originalsourceid><addsrcrecordid>eNqFkc1u1DAUhS0EokPhAdggC6liFbi2EzthN0xbaDWoixaxtFznunWVP-yk1bw9DhmohIRY2Za-c3zPPYS8ZvCeAagPEYDLMgMGGSjJM_GErFgueMYFF0_JCoTM052JA_IixjsApiTI5-SAg2J5WRUrEk4atKO_R3oxYEfvMcQp0q0ZTOij7Qdv6aW_aXtf000_o327o64P9Dhpwujt1Jj5EdFE_EjX9CuOJlt3ptlFH-mDH2_peIu_TAy9Ct40L8kzZ5qIr_bnIfl2enK1-ZJtLz6fbdbbzOYF8Mwpo7BQJee1hLJUACBdUVWudhItWnC1LQS469yCqnmNTJR5UQgOVrKK1-KQvFt8h9D_mDCOuvXRYtOYDvsp6hLKXIqCVYl8-xd5108hZZghVSgBlUwQWyCbNhMDOj0E35qw0wz0XIde6tCpDj3XoUXSvNkbT9ct1n8Uv_efgKM9YKI1jQumsz4-cqJkTFSzUbVwD77B3f9_1t_PLz-dQgrHk5Yv2phk3Q2Gx3T_nvwn4Q-yMQ</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>807573096</pqid></control><display><type>article</type><title>Elective Open versus Laparoscopic Sigmoid Colectomy for Diverticular Disease: A Meta-Analysis with the Sigma Trial</title><source>MEDLINE</source><source>Wiley Journals</source><source>SpringerLink Journals</source><creator>Siddiqui, Muhammed R. S. ; Sajid, Muhammed S. ; Khatri, Kamran ; Cheek, Elizabeth ; Baig, Mirza K.</creator><creatorcontrib>Siddiqui, Muhammed R. S. ; Sajid, Muhammed S. ; Khatri, Kamran ; Cheek, Elizabeth ; Baig, Mirza K.</creatorcontrib><description>Background
A meta-analysis of published literature comparing open versus laparoscopic elective sigmoid resections for diverticular disease was conducted.
Methods
Electronic databases were searched for data from January 1991 to March 2009. A systematic review was performed to obtain a summative outcome.
Results
Twenty-two comparative studies involving 10,898 patients were analyzed; 1538 patients were in the laparoscopic group and 9360 were in the open group. The operative time for laparoscopic sigmoid resection (LSR) is longer than open resections (OSR) [random-effects model: SMD = 1.94, 95% CI = (1.14, 2.74),
z
= 4.74,
p
< 0.001]. However, patients who undergo LSR have earlier return to passage of feces [random-effects model: SMD = −1.01, 95% CI (−1.80, −0.22),
z
= −2.50,
p
= 0.013] and shorter hospital stay [random-effects model: SMD = −7.65, 95% CI (−10.96, −4.32),
z
= −4.52,
p
< 0.001]. Overall morbidity was higher in the OSR group [random-effects model: RR = 0.56, 95% CI (0.40, 0.80),
z
= −3.24,
p
< 0.001] and no difference in mortality rates was observed (
p
= 0.81).
Conclusions
Laparoscopic sigmoid resection takes longer to perform than open procedures; however, it is safe and has lower overall morbidity, earlier return of bowel function, and shorter hospital stays. This approach should be considered for elective cases but more randomized controlled trials are required to strengthen the evidence.</description><identifier>ISSN: 0364-2313</identifier><identifier>EISSN: 1432-2323</identifier><identifier>DOI: 10.1007/s00268-010-0762-3</identifier><identifier>PMID: 20714895</identifier><identifier>CODEN: WJSUDI</identifier><language>eng</language><publisher>New York: Springer-Verlag</publisher><subject>Abdominal Surgery ; Biological and medical sciences ; Cardiac Surgery ; Colectomy - methods ; Digestive system. Abdomen ; Diverticular Disease ; Diverticulitis ; Diverticulosis, Colonic - surgery ; Endoscopy ; General aspects ; General Surgery ; Humans ; Investigative techniques, diagnostic techniques (general aspects) ; Laparoscopy ; Medical sciences ; Medicine ; Medicine & Public Health ; Risk Ratio ; Sigmoid Diseases - surgery ; Significant Heterogeneity ; Standardize Mean Difference ; Stomach, duodenum, intestine, rectum, anus ; Surgery ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Surgery of the digestive system ; Thoracic Surgery ; Vascular Surgery</subject><ispartof>World journal of surgery, 2010-12, Vol.34 (12), p.2883-2901</ispartof><rights>Société Internationale de Chirurgie 2010</rights><rights>2010 The Author(s) under exclusive licence to Société Internationale de Chirurgie</rights><rights>2015 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4502-f7a7e57822d608870006f599fdf6ecec0fdc530fb4c07d2de138455320c6192d3</citedby><cites>FETCH-LOGICAL-c4502-f7a7e57822d608870006f599fdf6ecec0fdc530fb4c07d2de138455320c6192d3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00268-010-0762-3$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00268-010-0762-3$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,1417,27924,27925,41488,42557,45574,45575,51319</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=23811393$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/20714895$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Siddiqui, Muhammed R. S.</creatorcontrib><creatorcontrib>Sajid, Muhammed S.</creatorcontrib><creatorcontrib>Khatri, Kamran</creatorcontrib><creatorcontrib>Cheek, Elizabeth</creatorcontrib><creatorcontrib>Baig, Mirza K.</creatorcontrib><title>Elective Open versus Laparoscopic Sigmoid Colectomy for Diverticular Disease: A Meta-Analysis with the Sigma Trial</title><title>World journal of surgery</title><addtitle>World J Surg</addtitle><addtitle>World J Surg</addtitle><description>Background
A meta-analysis of published literature comparing open versus laparoscopic elective sigmoid resections for diverticular disease was conducted.
Methods
Electronic databases were searched for data from January 1991 to March 2009. A systematic review was performed to obtain a summative outcome.
Results
Twenty-two comparative studies involving 10,898 patients were analyzed; 1538 patients were in the laparoscopic group and 9360 were in the open group. The operative time for laparoscopic sigmoid resection (LSR) is longer than open resections (OSR) [random-effects model: SMD = 1.94, 95% CI = (1.14, 2.74),
z
= 4.74,
p
< 0.001]. However, patients who undergo LSR have earlier return to passage of feces [random-effects model: SMD = −1.01, 95% CI (−1.80, −0.22),
z
= −2.50,
p
= 0.013] and shorter hospital stay [random-effects model: SMD = −7.65, 95% CI (−10.96, −4.32),
z
= −4.52,
p
< 0.001]. Overall morbidity was higher in the OSR group [random-effects model: RR = 0.56, 95% CI (0.40, 0.80),
z
= −3.24,
p
< 0.001] and no difference in mortality rates was observed (
p
= 0.81).
Conclusions
Laparoscopic sigmoid resection takes longer to perform than open procedures; however, it is safe and has lower overall morbidity, earlier return of bowel function, and shorter hospital stays. This approach should be considered for elective cases but more randomized controlled trials are required to strengthen the evidence.</description><subject>Abdominal Surgery</subject><subject>Biological and medical sciences</subject><subject>Cardiac Surgery</subject><subject>Colectomy - methods</subject><subject>Digestive system. Abdomen</subject><subject>Diverticular Disease</subject><subject>Diverticulitis</subject><subject>Diverticulosis, Colonic - surgery</subject><subject>Endoscopy</subject><subject>General aspects</subject><subject>General Surgery</subject><subject>Humans</subject><subject>Investigative techniques, diagnostic techniques (general aspects)</subject><subject>Laparoscopy</subject><subject>Medical sciences</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Risk Ratio</subject><subject>Sigmoid Diseases - surgery</subject><subject>Significant Heterogeneity</subject><subject>Standardize Mean Difference</subject><subject>Stomach, duodenum, intestine, rectum, anus</subject><subject>Surgery</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</subject><subject>Surgery of the digestive system</subject><subject>Thoracic Surgery</subject><subject>Vascular Surgery</subject><issn>0364-2313</issn><issn>1432-2323</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2010</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNqFkc1u1DAUhS0EokPhAdggC6liFbi2EzthN0xbaDWoixaxtFznunWVP-yk1bw9DhmohIRY2Za-c3zPPYS8ZvCeAagPEYDLMgMGGSjJM_GErFgueMYFF0_JCoTM052JA_IixjsApiTI5-SAg2J5WRUrEk4atKO_R3oxYEfvMcQp0q0ZTOij7Qdv6aW_aXtf000_o327o64P9Dhpwujt1Jj5EdFE_EjX9CuOJlt3ptlFH-mDH2_peIu_TAy9Ct40L8kzZ5qIr_bnIfl2enK1-ZJtLz6fbdbbzOYF8Mwpo7BQJee1hLJUACBdUVWudhItWnC1LQS469yCqnmNTJR5UQgOVrKK1-KQvFt8h9D_mDCOuvXRYtOYDvsp6hLKXIqCVYl8-xd5108hZZghVSgBlUwQWyCbNhMDOj0E35qw0wz0XIde6tCpDj3XoUXSvNkbT9ct1n8Uv_efgKM9YKI1jQumsz4-cqJkTFSzUbVwD77B3f9_1t_PLz-dQgrHk5Yv2phk3Q2Gx3T_nvwn4Q-yMQ</recordid><startdate>201012</startdate><enddate>201012</enddate><creator>Siddiqui, Muhammed R. S.</creator><creator>Sajid, Muhammed S.</creator><creator>Khatri, Kamran</creator><creator>Cheek, Elizabeth</creator><creator>Baig, Mirza K.</creator><general>Springer-Verlag</general><general>Springer‐Verlag</general><general>Springer</general><general>Springer Nature B.V</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7T5</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>201012</creationdate><title>Elective Open versus Laparoscopic Sigmoid Colectomy for Diverticular Disease: A Meta-Analysis with the Sigma Trial</title><author>Siddiqui, Muhammed R. S. ; Sajid, Muhammed S. ; Khatri, Kamran ; Cheek, Elizabeth ; Baig, Mirza K.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4502-f7a7e57822d608870006f599fdf6ecec0fdc530fb4c07d2de138455320c6192d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2010</creationdate><topic>Abdominal Surgery</topic><topic>Biological and medical sciences</topic><topic>Cardiac Surgery</topic><topic>Colectomy - methods</topic><topic>Digestive system. Abdomen</topic><topic>Diverticular Disease</topic><topic>Diverticulitis</topic><topic>Diverticulosis, Colonic - surgery</topic><topic>Endoscopy</topic><topic>General aspects</topic><topic>General Surgery</topic><topic>Humans</topic><topic>Investigative techniques, diagnostic techniques (general aspects)</topic><topic>Laparoscopy</topic><topic>Medical sciences</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Risk Ratio</topic><topic>Sigmoid Diseases - surgery</topic><topic>Significant Heterogeneity</topic><topic>Standardize Mean Difference</topic><topic>Stomach, duodenum, intestine, rectum, anus</topic><topic>Surgery</topic><topic>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</topic><topic>Surgery of the digestive system</topic><topic>Thoracic Surgery</topic><topic>Vascular Surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Siddiqui, Muhammed R. S.</creatorcontrib><creatorcontrib>Sajid, Muhammed S.</creatorcontrib><creatorcontrib>Khatri, Kamran</creatorcontrib><creatorcontrib>Cheek, Elizabeth</creatorcontrib><creatorcontrib>Baig, Mirza K.</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>Immunology Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>World journal of surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Siddiqui, Muhammed R. S.</au><au>Sajid, Muhammed S.</au><au>Khatri, Kamran</au><au>Cheek, Elizabeth</au><au>Baig, Mirza K.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Elective Open versus Laparoscopic Sigmoid Colectomy for Diverticular Disease: A Meta-Analysis with the Sigma Trial</atitle><jtitle>World journal of surgery</jtitle><stitle>World J Surg</stitle><addtitle>World J Surg</addtitle><date>2010-12</date><risdate>2010</risdate><volume>34</volume><issue>12</issue><spage>2883</spage><epage>2901</epage><pages>2883-2901</pages><issn>0364-2313</issn><eissn>1432-2323</eissn><coden>WJSUDI</coden><abstract>Background
A meta-analysis of published literature comparing open versus laparoscopic elective sigmoid resections for diverticular disease was conducted.
Methods
Electronic databases were searched for data from January 1991 to March 2009. A systematic review was performed to obtain a summative outcome.
Results
Twenty-two comparative studies involving 10,898 patients were analyzed; 1538 patients were in the laparoscopic group and 9360 were in the open group. The operative time for laparoscopic sigmoid resection (LSR) is longer than open resections (OSR) [random-effects model: SMD = 1.94, 95% CI = (1.14, 2.74),
z
= 4.74,
p
< 0.001]. However, patients who undergo LSR have earlier return to passage of feces [random-effects model: SMD = −1.01, 95% CI (−1.80, −0.22),
z
= −2.50,
p
= 0.013] and shorter hospital stay [random-effects model: SMD = −7.65, 95% CI (−10.96, −4.32),
z
= −4.52,
p
< 0.001]. Overall morbidity was higher in the OSR group [random-effects model: RR = 0.56, 95% CI (0.40, 0.80),
z
= −3.24,
p
< 0.001] and no difference in mortality rates was observed (
p
= 0.81).
Conclusions
Laparoscopic sigmoid resection takes longer to perform than open procedures; however, it is safe and has lower overall morbidity, earlier return of bowel function, and shorter hospital stays. This approach should be considered for elective cases but more randomized controlled trials are required to strengthen the evidence.</abstract><cop>New York</cop><pub>Springer-Verlag</pub><pmid>20714895</pmid><doi>10.1007/s00268-010-0762-3</doi><tpages>19</tpages></addata></record> |
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| ispartof | World journal of surgery, 2010-12, Vol.34 (12), p.2883-2901 |
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| source | MEDLINE; Wiley Journals; SpringerLink Journals |
| subjects | Abdominal Surgery Biological and medical sciences Cardiac Surgery Colectomy - methods Digestive system. Abdomen Diverticular Disease Diverticulitis Diverticulosis, Colonic - surgery Endoscopy General aspects General Surgery Humans Investigative techniques, diagnostic techniques (general aspects) Laparoscopy Medical sciences Medicine Medicine & Public Health Risk Ratio Sigmoid Diseases - surgery Significant Heterogeneity Standardize Mean Difference Stomach, duodenum, intestine, rectum, anus Surgery Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Surgery of the digestive system Thoracic Surgery Vascular Surgery |
| title | Elective Open versus Laparoscopic Sigmoid Colectomy for Diverticular Disease: A Meta-Analysis with the Sigma Trial |
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