Evidence map›Paper›PMID 25516678›Full record

SynthesisWorld journal of gastroenterology2014

Meta-analysis of laparoscopic vs open cholecystectomy in elderly patients.

Stavros A Antoniou, George A Antoniou, Oliver O Koch, Rudolph Pointner, Frank A Granderath

Abstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in World journal of gastroenterology, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 42 papers, 8 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
42citing papers in PubMed, 8 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

42 citing papers in PubMed, 8 syntheses or guidelines pooled it.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Stavros A AntoniouStavros A Antoniou, Frank A Granderath, Center for Minimally Invasive Surgery, Hospital Neuwerk, 41066 Mönchengladbach, Germany.
George A AntoniouStavros A Antoniou, Frank A Granderath, Center for Minimally Invasive Surgery, Hospital Neuwerk, 41066 Mönchengladbach, Germany.
Oliver O KochStavros A Antoniou, Frank A Granderath, Center for Minimally Invasive Surgery, Hospital Neuwerk, 41066 Mönchengladbach, Germany.
Rudolph PointnerStavros A Antoniou, Frank A Granderath, Center for Minimally Invasive Surgery, Hospital Neuwerk, 41066 Mönchengladbach, Germany.
Frank A GranderathStavros A Antoniou, Frank A Granderath, Center for Minimally Invasive Surgery, Hospital Neuwerk, 41066 Mönchengladbach, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimTo investigate the comparative effect of laparoscopic and open cholecystectomy in elderly patients.

methodsLaparoscopic cholecystectomy has induced a revolution in the treatment of gallbladder disease. Nevertheless, surgeons have been reluctant to implement the concepts of minimally invasive surgery in older patients. A systematic review of Medline was embarked on, up to June 2013. Studies which provided outcome data on patients aged 65 years or older, subjected to laparoscopic or open cholecystectomy were considered. Mortality, morbidity, cardiac and pulmonary complications were the outcome measures of treatment effect. The methodological quality of selected studies was appraised using valid assessment tools. Τhe random-effects model was applied to synthesize outcome data.

resultsOut of a total of 337 records, thirteen articles (2 randomized and 11 observational studies) reporting on the outcome of 101559 patients (48195 in the laparoscopic and 53364 in the open treatment group, respectively) were identified. Odds ratios (OR) were constantly in favor of laparoscopic surgery, in terms of mortality (1.0% vs 4.4%, OR = 0.24, 95%CI: 0.17-0.35, P < 0.00001), morbidity (11.5% vs 21.3%, OR = 0.44, 95%CI: 0.33-0.59, P < 0.00001), cardiac (0.6% vs 1.2%, OR = 0.55, 95%CI: 0.38-0.80, P = 0.002) and respiratory complications (2.8% vs 5.0%, OR = 0.55, 95%CI: 0.51-0.60, P < 0.00001). Critical analysis of solid study data, demonstrated a trend towards improved outcomes for the laparoscopic concept, when adjusted for age and co-morbid diseases.

conclusionFurther high-quality evidence is necessary to draw definite conclusions, although best-available evidence supports the selective use of laparoscopy in this patient population.

Indexed as

AgedAged, 80 and overAge FactorsChi-Square DistributionCholecystectomyCholecystectomy, LaparoscopicHumansOdds RatioPatient SelectionRisk AssessmentRisk FactorsTreatment OutcomeComplicationsElderlyGeriatricLaparoscopicMorbidityMortalityOlderOpen cholecystectomySurgery

Identifiers

PMID25516678
PMCPMC4265625

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.