Department of Anorectal Surgery, The First Hospital of China Medical University, Shenyang, 110001, Liaoning, China.
World J Emerg Surg. 2022 May 26;17(1):26. doi: 10.1186/s13017-022-00431-1.
This paper compares the postoperative recovery of patients with acute appendicitis (AA) after laparoscopic appendectomy (LA) and open appendectomy (OA), aiming to determine the optimal diagnosis and treatment plan for appendectomy.
Related literature was retrieved from PubMed, Web of Science, Embase, CNKI and Wanfang databases. Articles on LA and OA for AA published between 2010 and 2021 were selected to extract data. Besides, Stata16.0 was used for meta-analysis.
A total of 777 articles were retrieved, and 16 of them were finally selected. Totally, 1251 patients underwent LA, while 898 patients received OA. According to the results of meta-analysis, LA was associated with lower incidence of adverse reactions [OR = 0.257, 95% CI (0.162, 0.408), P < 0.001], shorter operation time (SMD = - 1.802, 95% CI - 2.435, - 1.169; P < 0.001) and hospitalization (SMD = - 1.184, 95% CI - 1.512, - 0.856; P < 0.001). In addition, compared with the OA group, LA was found with less intraoperative blood loss (SMD = - 3.650, 95% CI - 5.088, - 2.212; P < 0.001) and shorter recovery time of gastrointestinal function (SMD = - 3.010, 95% CI - 3.816, - 2.203; P < 0.001). Aside from all these, the counts of leukocyte (SMD = - 0.432, 95% CI: - 0.775, - 0.089; P = 0.013), neutrophil (SMD = - 1.346, 95% CI - 2.560, - 0.133; P = 0.030), and C-reactive protein (SMD = - 2.391, 95% CI - 3.901, - 0.882; P = 0.002) all decreased in a significant manner after LA.
Compared with OA, LA boasts the advantages of less adverse reactions, shorter operation time and hospitalization, fewer complications, and lower inflammatory response, evidencing its safety and feasibility of applying in the treatment of AA.
本研究旨在比较急性阑尾炎（AA）患者行腹腔镜阑尾切除术（LA）与开腹阑尾切除术（OA）后的术后恢复情况，以确定阑尾切除术的最佳诊断和治疗方案。
检索 PubMed、Web of Science、Embase、中国知网（CNKI）和万方数据库中 2010 年至 2021 年发表的关于 LA 和 OA 治疗 AA 的相关文献，提取数据。采用 Stata16.0 软件进行荟萃分析。
共检索到 777 篇文献，最终纳入 16 篇文献。共 1251 例患者接受 LA 治疗，898 例患者接受 OA 治疗。荟萃分析结果显示，LA 组不良反应发生率较低[OR=0.257，95%CI（0.162，0.408），P<0.001]，手术时间[SMD=-1.802，95%CI（-2.435，-1.169），P<0.001]和住院时间[SMD=-1.184，95%CI（-1.512，-0.856），P<0.001]更短。此外，与 OA 组相比，LA 术中出血量更少[SMD=-3.650，95%CI（-5.088，-2.212），P<0.001]，胃肠功能恢复时间更短[SMD=-3.010，95%CI（-3.816，-2.203），P<0.001]。此外，LA 组白细胞计数[SMD=-0.432，95%CI：（-0.775，-0.089），P=0.013]、中性粒细胞计数[SMD=-1.346，95%CI（-2.560，-0.133），P=0.030]和 C 反应蛋白[SMD=-2.391，95%CI（-3.901，-0.882），P=0.002]均显著降低。
与 OA 相比，LA 具有不良反应少、手术时间和住院时间短、并发症少、炎症反应低等优点，证明其在治疗 AA 方面安全可行。
