Laparoscopic Major Gastrointestinal Surgery Is Safe for Properly Selected Patient with COPD: A Meta-Analysis
Background. Laparoscopy has been widely applied in gastrointestinal surgery, with benefits such as less intraoperative blood loss, faster recovery, and shorter length of hospital stay. However, it remains controversial if laparoscopic major gastrointestinal surgery could be conducted for patients wi...
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| Veröffentlicht in: | BioMed research international 2019-01, Vol.2019 (2019), p.1-8 |
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| description | Background. Laparoscopy has been widely applied in gastrointestinal surgery, with benefits such as less intraoperative blood loss, faster recovery, and shorter length of hospital stay. However, it remains controversial if laparoscopic major gastrointestinal surgery could be conducted for patients with chronic obstructive pulmonary disease (COPD) which was traditionally considered as an important risk factor for postoperative pulmonary complications. The present study was conducted to review and assess the safety and feasibility of laparoscopic major abdominal surgery for patient with COPD. Materials and Methods. Databases including PubMed, EmBase, Cochrane Library, and Wan-fang were searched for all years up to Jul 1, 2018. Studies comparing perioperative results for COPD patients undergoing major gastrointestinal surgery between laparoscopic and open approaches were enrolled. Results. Laparoscopic approach was associated with less intraoperative blood loss (MD = -174.03; 95% CI: −232.16 to -115.91, P < 0.00001; P < 0.00001, I2=93% for heterogeneity) and shorter length of hospital stay (MD = -3.30; 95% CI: −3.75 to -2.86, P < 0.00001; P = 0.99, I2=0% for heterogeneity). As for pulmonary complications, laparoscopic approach was associated with lower overall pulmonary complications rate (OR = 0.58; 95% CI: 0.48 to 0.71, P < 0.00001; P = 0.42, I2=0% for heterogeneity) and lower postoperative pneumonia rate (OR = 0.53; 95% CI: 0.41 to 0.67, P < 0.00001; P = 0.57, I2=0% for heterogeneity). Moreover, laparoscopic approach was associated with lower wound infection (OR = 0.51; 95% CI: 0.42 to 0.63, P < 0.00001; P = 0.99, I2=0% for heterogeneity) and abdominal abscess rates (OR = 0.59; 95% CI: 0.44 to 0.79, P < 0.0004; P = 0.24, I2=30% for heterogeneity). Conclusions. Laparoscopic major gastrointestinal surgery for properly selected COPD patient was safe and feasible, with shorter term benefits. |
| doi_str_mv | 10.1155/2019/8280358 |
| format | Article |
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Laparoscopy has been widely applied in gastrointestinal surgery, with benefits such as less intraoperative blood loss, faster recovery, and shorter length of hospital stay. However, it remains controversial if laparoscopic major gastrointestinal surgery could be conducted for patients with chronic obstructive pulmonary disease (COPD) which was traditionally considered as an important risk factor for postoperative pulmonary complications. The present study was conducted to review and assess the safety and feasibility of laparoscopic major abdominal surgery for patient with COPD. Materials and Methods. Databases including PubMed, EmBase, Cochrane Library, and Wan-fang were searched for all years up to Jul 1, 2018. Studies comparing perioperative results for COPD patients undergoing major gastrointestinal surgery between laparoscopic and open approaches were enrolled. Results. Laparoscopic approach was associated with less intraoperative blood loss (MD = -174.03; 95% CI: −232.16 to -115.91, P < 0.00001; P < 0.00001, I2=93% for heterogeneity) and shorter length of hospital stay (MD = -3.30; 95% CI: −3.75 to -2.86, P < 0.00001; P = 0.99, I2=0% for heterogeneity). As for pulmonary complications, laparoscopic approach was associated with lower overall pulmonary complications rate (OR = 0.58; 95% CI: 0.48 to 0.71, P < 0.00001; P = 0.42, I2=0% for heterogeneity) and lower postoperative pneumonia rate (OR = 0.53; 95% CI: 0.41 to 0.67, P < 0.00001; P = 0.57, I2=0% for heterogeneity). Moreover, laparoscopic approach was associated with lower wound infection (OR = 0.51; 95% CI: 0.42 to 0.63, P < 0.00001; P = 0.99, I2=0% for heterogeneity) and abdominal abscess rates (OR = 0.59; 95% CI: 0.44 to 0.79, P < 0.0004; P = 0.24, I2=30% for heterogeneity). Conclusions. Laparoscopic major gastrointestinal surgery for properly selected COPD patient was safe and feasible, with shorter term benefits.]]></description><identifier>ISSN: 2314-6133</identifier><identifier>EISSN: 2314-6141</identifier><identifier>DOI: 10.1155/2019/8280358</identifier><identifier>PMID: 30941372</identifier><language>eng</language><publisher>Cairo, Egypt: Hindawi Publishing Corporation</publisher><subject>Aged ; Biomedical research ; Chronic obstructive pulmonary disease ; Feasibility studies ; Female ; Gastroenterology ; Gastrointestinal surgery ; Gastrointestinal Tract - surgery ; Health aspects ; Heterogeneity ; Humans ; Intraoperative Care ; Laparoscopic surgery ; Laparoscopy ; Lung diseases ; Male ; Medical research ; Medicine, Experimental ; Meta-analysis ; Middle Aged ; Obstructive lung disease ; Patients ; Postoperative Care ; Publication Bias ; Pulmonary Disease, Chronic Obstructive - surgery ; Risk analysis ; Risk factors ; Sensitivity analysis ; Statistical analysis ; Studies ; Surgery ; Surgical outcomes ; Surgical techniques ; Systematic review ; Wound infection</subject><ispartof>BioMed research international, 2019-01, Vol.2019 (2019), p.1-8</ispartof><rights>Copyright © 2019 Yulin Guo et al.</rights><rights>COPYRIGHT 2019 John Wiley & Sons, Inc.</rights><rights>Copyright © 2019 Yulin Guo et al. This is an open access article distributed under the Creative Commons Attribution License (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. https://creativecommons.org/licenses/by/4.0</rights><rights>Copyright © 2019 Yulin Guo et al. 2019</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c499t-b5b89c165a6b53a51d8e3e3c160f7414760dc81b00d8c9620a0c8d984a9795c3</citedby><cites>FETCH-LOGICAL-c499t-b5b89c165a6b53a51d8e3e3c160f7414760dc81b00d8c9620a0c8d984a9795c3</cites><orcidid>0000-0002-0532-9054</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6420973/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6420973/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,27924,27925,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30941372$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Mariscalco, Giovanni</contributor><contributor>Giovanni Mariscalco</contributor><creatorcontrib>Li, Fei</creatorcontrib><creatorcontrib>Liu, Shuang</creatorcontrib><creatorcontrib>Sun, Haichen</creatorcontrib><creatorcontrib>Ding, Yixuan</creatorcontrib><creatorcontrib>Cao, Feng</creatorcontrib><creatorcontrib>Guo, Yulin</creatorcontrib><creatorcontrib>Li, Ang</creatorcontrib><title>Laparoscopic Major Gastrointestinal Surgery Is Safe for Properly Selected Patient with COPD: A Meta-Analysis</title><title>BioMed research international</title><addtitle>Biomed Res Int</addtitle><description><![CDATA[Background. Laparoscopy has been widely applied in gastrointestinal surgery, with benefits such as less intraoperative blood loss, faster recovery, and shorter length of hospital stay. However, it remains controversial if laparoscopic major gastrointestinal surgery could be conducted for patients with chronic obstructive pulmonary disease (COPD) which was traditionally considered as an important risk factor for postoperative pulmonary complications. The present study was conducted to review and assess the safety and feasibility of laparoscopic major abdominal surgery for patient with COPD. Materials and Methods. Databases including PubMed, EmBase, Cochrane Library, and Wan-fang were searched for all years up to Jul 1, 2018. Studies comparing perioperative results for COPD patients undergoing major gastrointestinal surgery between laparoscopic and open approaches were enrolled. Results. Laparoscopic approach was associated with less intraoperative blood loss (MD = -174.03; 95% CI: −232.16 to -115.91, P < 0.00001; P < 0.00001, I2=93% for heterogeneity) and shorter length of hospital stay (MD = -3.30; 95% CI: −3.75 to -2.86, P < 0.00001; P = 0.99, I2=0% for heterogeneity). As for pulmonary complications, laparoscopic approach was associated with lower overall pulmonary complications rate (OR = 0.58; 95% CI: 0.48 to 0.71, P < 0.00001; P = 0.42, I2=0% for heterogeneity) and lower postoperative pneumonia rate (OR = 0.53; 95% CI: 0.41 to 0.67, P < 0.00001; P = 0.57, I2=0% for heterogeneity). Moreover, laparoscopic approach was associated with lower wound infection (OR = 0.51; 95% CI: 0.42 to 0.63, P < 0.00001; P = 0.99, I2=0% for heterogeneity) and abdominal abscess rates (OR = 0.59; 95% CI: 0.44 to 0.79, P < 0.0004; P = 0.24, I2=30% for heterogeneity). Conclusions. Laparoscopic major gastrointestinal surgery for properly selected COPD patient was safe and feasible, with shorter term benefits.]]></description><subject>Aged</subject><subject>Biomedical research</subject><subject>Chronic obstructive pulmonary disease</subject><subject>Feasibility studies</subject><subject>Female</subject><subject>Gastroenterology</subject><subject>Gastrointestinal surgery</subject><subject>Gastrointestinal Tract - surgery</subject><subject>Health aspects</subject><subject>Heterogeneity</subject><subject>Humans</subject><subject>Intraoperative Care</subject><subject>Laparoscopic surgery</subject><subject>Laparoscopy</subject><subject>Lung diseases</subject><subject>Male</subject><subject>Medical research</subject><subject>Medicine, Experimental</subject><subject>Meta-analysis</subject><subject>Middle Aged</subject><subject>Obstructive lung disease</subject><subject>Patients</subject><subject>Postoperative Care</subject><subject>Publication Bias</subject><subject>Pulmonary Disease, Chronic Obstructive - surgery</subject><subject>Risk analysis</subject><subject>Risk factors</subject><subject>Sensitivity analysis</subject><subject>Statistical analysis</subject><subject>Studies</subject><subject>Surgery</subject><subject>Surgical outcomes</subject><subject>Surgical techniques</subject><subject>Systematic review</subject><subject>Wound infection</subject><issn>2314-6133</issn><issn>2314-6141</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>RHX</sourceid><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNqNkUtrGzEURofS0oQ0u66LoJtCM41eo0cXAeOmacAhBmcvrjUaW2Y8mkozDf73lbHrPlbVRkI6fPdenaJ4S_AnQqrqmmKirxVVmFXqRXFOGeGlIJy8PJ0ZOysuU9rgvBQRWIvXxRnDmhMm6XnRzqCHGJINvbfoATYhojtIQwy-G1wafActWoxx5eIO3Se0gMahJkPzGHoX2x1auNbZwdVoDoN33YCe_bBG08f5l89ogh7cAOUkh-yST2-KVw20yV0e94vi6evt0_RbOXu8u59OZqXlWg_lsloqbYmoQCwrBhWplWOO5RvcSE64FLi2iiwxrpXVgmLAVtVacdBSV5ZdFDeH2H5cbl1tc1MRWtNHv4W4MwG8-ful82uzCj-M4BRryXLAh2NADN_H_Atm65N1bQudC2MylGIqpGZEZ_T9P-gmjDHPmymidO5VZTknagWtM75rQq5r96FmIijnRHIpM3V1oGwWkqJrTi0TbPa6zV63OerO-Ls_xzzBv-Rm4OMBWPuuhmf_n3EuM66B3zShUjHKfgKzJLo9</recordid><startdate>20190101</startdate><enddate>20190101</enddate><creator>Li, Fei</creator><creator>Liu, Shuang</creator><creator>Sun, Haichen</creator><creator>Ding, Yixuan</creator><creator>Cao, Feng</creator><creator>Guo, Yulin</creator><creator>Li, Ang</creator><general>Hindawi Publishing Corporation</general><general>Hindawi</general><general>John Wiley & Sons, Inc</general><general>Hindawi Limited</general><scope>ADJCN</scope><scope>AHFXO</scope><scope>RHU</scope><scope>RHW</scope><scope>RHX</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>7QL</scope><scope>7QO</scope><scope>7T7</scope><scope>7TK</scope><scope>7U7</scope><scope>7U9</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>CWDGH</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-0532-9054</orcidid></search><sort><creationdate>20190101</creationdate><title>Laparoscopic Major Gastrointestinal Surgery Is Safe for Properly Selected Patient with COPD: A Meta-Analysis</title><author>Li, Fei ; Liu, Shuang ; Sun, Haichen ; Ding, Yixuan ; Cao, Feng ; Guo, Yulin ; Li, Ang</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c499t-b5b89c165a6b53a51d8e3e3c160f7414760dc81b00d8c9620a0c8d984a9795c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Aged</topic><topic>Biomedical research</topic><topic>Chronic obstructive pulmonary disease</topic><topic>Feasibility studies</topic><topic>Female</topic><topic>Gastroenterology</topic><topic>Gastrointestinal surgery</topic><topic>Gastrointestinal Tract - surgery</topic><topic>Health aspects</topic><topic>Heterogeneity</topic><topic>Humans</topic><topic>Intraoperative Care</topic><topic>Laparoscopic surgery</topic><topic>Laparoscopy</topic><topic>Lung diseases</topic><topic>Male</topic><topic>Medical research</topic><topic>Medicine, Experimental</topic><topic>Meta-analysis</topic><topic>Middle Aged</topic><topic>Obstructive lung disease</topic><topic>Patients</topic><topic>Postoperative Care</topic><topic>Publication Bias</topic><topic>Pulmonary Disease, Chronic Obstructive - surgery</topic><topic>Risk analysis</topic><topic>Risk factors</topic><topic>Sensitivity analysis</topic><topic>Statistical analysis</topic><topic>Studies</topic><topic>Surgery</topic><topic>Surgical outcomes</topic><topic>Surgical techniques</topic><topic>Systematic review</topic><topic>Wound infection</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Li, Fei</creatorcontrib><creatorcontrib>Liu, Shuang</creatorcontrib><creatorcontrib>Sun, Haichen</creatorcontrib><creatorcontrib>Ding, Yixuan</creatorcontrib><creatorcontrib>Cao, Feng</creatorcontrib><creatorcontrib>Guo, Yulin</creatorcontrib><creatorcontrib>Li, Ang</creatorcontrib><collection>الدوريات العلمية والإحصائية - 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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>BioMed research international</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Li, Fei</au><au>Liu, Shuang</au><au>Sun, Haichen</au><au>Ding, Yixuan</au><au>Cao, Feng</au><au>Guo, Yulin</au><au>Li, Ang</au><au>Mariscalco, Giovanni</au><au>Giovanni Mariscalco</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Laparoscopic Major Gastrointestinal Surgery Is Safe for Properly Selected Patient with COPD: A Meta-Analysis</atitle><jtitle>BioMed research international</jtitle><addtitle>Biomed Res Int</addtitle><date>2019-01-01</date><risdate>2019</risdate><volume>2019</volume><issue>2019</issue><spage>1</spage><epage>8</epage><pages>1-8</pages><issn>2314-6133</issn><eissn>2314-6141</eissn><abstract><![CDATA[Background. Laparoscopy has been widely applied in gastrointestinal surgery, with benefits such as less intraoperative blood loss, faster recovery, and shorter length of hospital stay. However, it remains controversial if laparoscopic major gastrointestinal surgery could be conducted for patients with chronic obstructive pulmonary disease (COPD) which was traditionally considered as an important risk factor for postoperative pulmonary complications. The present study was conducted to review and assess the safety and feasibility of laparoscopic major abdominal surgery for patient with COPD. Materials and Methods. Databases including PubMed, EmBase, Cochrane Library, and Wan-fang were searched for all years up to Jul 1, 2018. Studies comparing perioperative results for COPD patients undergoing major gastrointestinal surgery between laparoscopic and open approaches were enrolled. Results. Laparoscopic approach was associated with less intraoperative blood loss (MD = -174.03; 95% CI: −232.16 to -115.91, P < 0.00001; P < 0.00001, I2=93% for heterogeneity) and shorter length of hospital stay (MD = -3.30; 95% CI: −3.75 to -2.86, P < 0.00001; P = 0.99, I2=0% for heterogeneity). As for pulmonary complications, laparoscopic approach was associated with lower overall pulmonary complications rate (OR = 0.58; 95% CI: 0.48 to 0.71, P < 0.00001; P = 0.42, I2=0% for heterogeneity) and lower postoperative pneumonia rate (OR = 0.53; 95% CI: 0.41 to 0.67, P < 0.00001; P = 0.57, I2=0% for heterogeneity). Moreover, laparoscopic approach was associated with lower wound infection (OR = 0.51; 95% CI: 0.42 to 0.63, P < 0.00001; P = 0.99, I2=0% for heterogeneity) and abdominal abscess rates (OR = 0.59; 95% CI: 0.44 to 0.79, P < 0.0004; P = 0.24, I2=30% for heterogeneity). Conclusions. Laparoscopic major gastrointestinal surgery for properly selected COPD patient was safe and feasible, with shorter term benefits.]]></abstract><cop>Cairo, Egypt</cop><pub>Hindawi Publishing Corporation</pub><pmid>30941372</pmid><doi>10.1155/2019/8280358</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0002-0532-9054</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Aged Biomedical research Chronic obstructive pulmonary disease Feasibility studies Female Gastroenterology Gastrointestinal surgery Gastrointestinal Tract - surgery Health aspects Heterogeneity Humans Intraoperative Care Laparoscopic surgery Laparoscopy Lung diseases Male Medical research Medicine, Experimental Meta-analysis Middle Aged Obstructive lung disease Patients Postoperative Care Publication Bias Pulmonary Disease, Chronic Obstructive - surgery Risk analysis Risk factors Sensitivity analysis Statistical analysis Studies Surgery Surgical outcomes Surgical techniques Systematic review Wound infection |
| title | Laparoscopic Major Gastrointestinal Surgery Is Safe for Properly Selected Patient with COPD: A Meta-Analysis |
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