Evidence map›Paper›PMID 27369964›Full record

SynthesisPediatric surgery international2016

Laparoscopic-assisted pull-through operation for Hirschsprung's disease: a systematic review and meta-analysis.

C Tomuschat, J Zimmer, P Puri

Registry-linked trialAbstract readSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Pediatric surgery international, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03269812 (Laparoscopic Assisted Pull-through Versus Other Surgical Procedures for Treatment of Hirschsprung Disease.), which is not on this map. Cited by 26 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
26citing papers in PubMed, 3 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.

NCT03269812 naunknown statusnot on this mapstarted 2017, after this paper: background citation

Laparoscopic Assisted Pull-through Versus Other Surgical Procedures for Treatment of Hirschsprung Disease.

TypeinterventionalSponsorAssiut UniversityRan2017 to 2019Enrolled60ConditionsHirschsprung DiseaseArmslaparoscopic assisted pull-through oeration
3 · Its place in the literature

Who cites it

26 citing papers in PubMed, 3 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

3 authors.

C TomuschatNational Children's Research Centre, Our Lady's Children's Hospital, Crumlin, Dublin, Ireland.
J ZimmerNational Children's Research Centre, Our Lady's Children's Hospital, Crumlin, Dublin, Ireland.
P PuriNational Children's Research Centre, Our Lady's Children's Hospital, Crumlin, Dublin, Ireland. prem.puri@ucd.ie.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeIn the last two decades, laparoscopic-assisted pull-through (LAPT) has gained much popularity in the treatment of Hirschsprung's disease. The aim of this meta-analysis was to determine the long-term outcome of patients treated laparoscopically.

methodsA systematic literature-based search for relevant cohorts was performed using the terms "Hirschsprung's disease and Laparoscopy", "Laparoscopic-assisted pull-through outcome", "Laparoscopic-assisted Soave pull-through" "Laparoscopic-assisted Swenson pull-through" and Laparoscopic-assisted Duhamel pull-through. The relevant cohorts of laparoscopic operated HD were systematically searched for outcome regarding continence, constipation, secondary surgery related to the laparoscopic approach and enterocolitis. Pooled incidence rates and odds ratios (ORs) with 95 % confidence intervals (CI) were calculated using standardized statistical methodology.

resultsSixteen studies met defined inclusion criteria, reporting a total of 820 patients. All studies were retrospective case series, with variability in outcome assessment quality and length of follow-up. The median cohort size consisted of 28 patients (range 15-218). In the long-term follow-up, 97 patients (11.14 %) experienced constipation (OR 0.06, 95 % CI 0.05-0.08, p < 0.00001), 53 (6.46 %) incontinence/soiling (OR 0.01 95 % CI 0.01-0.01, p < 0.00001), 75 (9.14 %) recurrent enterocolitis (OR 0.02 95 % CI 0.01-0.02, p < 0.00001) and 69 (8.4 %) developed complications requiring secondary surgery (OR 0.01 95 % CI 0.01-0.02, p < 0.00001). Overall events in long-term follow-up occurred in 225 (27.5 %) patients (OR 0.24 95 % CI 0.20-0.30, p < 0.00001).

conclusionsThis meta-analysis shows that nearly one-third of the patients continue to have long-term bowel problems, such as constipation, soiling and recurrent enterocolitis following LAPT. Many patients treated by LAPT require secondary surgery. Large randomized studies with long-term follow-up are necessary to determine the difference in outcome between LAPT and completely transanal pull-through operation.

Indexed as

LaparoscopyConstipationDigestive System Surgical ProceduresEnterocolitisFecal IncontinenceHirschsprung DiseaseHumansRecurrenceHirschsprung’s diseaseLaparoscopic-assisted pull-throughMeta-analysis

Identifiers

PMID27369964

What OpenQuestion holds

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Registered trials

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.