Evidence map›Paper›PMID 26979491›Full record

SynthesisBMC gastroenterology2016

Evidence of surgical outcomes fluctuates over time: results from a cumulative meta-analysis of laparoscopic versus open appendectomy for acute appendicitis.

Tomohiko Ukai, Satoru Shikata, Hiromu Takeda, Lauren Dawes, Yoshinori Noguchi, Takeo Nakayama, Yousuke C Takemura

Abstract readComparative StudyMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BMC gastroenterology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
28citing papers in PubMed, 5 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

28 citing papers in PubMed, 5 syntheses or guidelines pooled it.

  1. Appendectomy versus antibiotic treatment for acute appendicitis.The Cochrane database of systematic reviews · 2024
    Pooled it
  2. Pooled it
  3. Laparoscopic Repair for Perforated Peptic Ulcer Disease Has Better Outcomes Than Open Repair.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2019
    Pooled it
  4. Laparoscopic versus open surgery for suspected appendicitis.The Cochrane database of systematic reviews · 2018
    Pooled it
  5. Pooled it
  6. Article
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  11. Review
  12. Article
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  15. Risk factors for postoperative morbidity following appendectomy in the elderly: a nationwide prospective cohort study.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2021
    Article
  16. Review
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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

7 authors.

Tomohiko UkaiDepartment of Community Medicine, Mie University School of Medicine, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan.
Satoru ShikataDepartment of Family Medicine, Mie University School of Medicine & Graduate School of Medicine, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan. shikata-s@umin.org.
Hiromu TakedaDepartment of Family Medicine, Mie Prefectural Ichishi Hospital, 616 Minamiieki, Hakunsan-cho, Tsu, Mie, 515-3133, Japan.
Lauren DawesDepartment of Surgery, Flinders Medical Centre, Bedford Park, SA, 5042, Australia.
Yoshinori NoguchiGeneral Internal Medicine, Japanese Red Cross Nagoya Daini Hospital, 2-9 Myoken-cho, Showa-ku, Nagoya, 466-8650, Aichi, Japan.
Takeo NakayamaDepartment of Health Informatics, Kyoto University School of Public Health, Konoe-cho, Yoshida, Sakyo-ku, Kyoto, 606-8501, Japan.
Yousuke C TakemuraDepartment of Family Medicine, Mie University School of Medicine & Graduate School of Medicine, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIn surgical trials, complex variables such as equipment development and surgeons' learning curve are involved. The evidence obtained in these trials can thus fluctuate over time. We explored the stability of the evidence obtained during surgery by conducting a cumulative meta-analysis of randomized controlled trials for open and laparoscopic appendectomy.

methodsWe conducted a cumulative meta-analysis of randomized controlled trials comparing laparoscopic appendectomy with open appendectomy for acute appendicitis, a topic with the greatest number of trials in the gastroenterological surgical field. We searched the MEDLINE (PubMed), EMBASE, and CINAHL databases up to September 2014 and reviewed the bibliographies. Outcomes were the incidence of intra-abdominal abscess, incidence of wound infection, operative time, and length of hospital stay. We used the 95 % confidence interval (95 % CI) of effect size for the significance test.

resultsSixty-four trials were included in this analysis. Of the 51 trials addressing intra-abdominal abscesses, our cumulative meta-analysis of trials published up to and including 2001 demonstrated statistical significance in favor of open appendectomy (cumulative odds ratio [OR] 2.35, 95 % CI 1.30-4.25). The effect size in favor of open procedures began to disappear after 2001, leading to an insignificant result with an overall cumulative OR of 1.32 (95 % CI 0.84-2.10) when laparoscopic appendectomy was compared with open appendectomy.

conclusionsThe evidence regarding treatment effectiveness changed over time, after treatment effectiveness became significant in trials comparing laparoscopic and open appendectomy. Observing only the 95 % confidence interval of effect size from a meta-analysis may not provide conclusive results.

Indexed as

Abdominal AbscessAcute DiseaseAppendectomyAppendicitisHumansIncidenceLaparoscopyLength of StayOdds RatioOperative TimePostoperative ComplicationsRandomized Controlled Trials as TopicSurgical Wound InfectionTreatment OutcomeCumulative meta-analysisLaparoscopic appendectomyOpen appendectomyRandomized controlled trials

Identifiers

PMID26979491
PMCPMC4793521

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.