Evidence map›Paper›PMID 36001167›Full record

ArticleInternational journal of colorectal disease2022

Laparoscopic rectal resection without epidural catheters-does it work?

M El-Ahmar, F Koch, A Köhler, L Moikow, M Ristig, J-P Ritz

Erratum issuedAbstract read
PubMed Publisher
In one paragraph

Article in International journal of colorectal disease, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.2field-weighted citation impact, top 46% of its field
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

2 citing papers in PubMed, 1 citations in OpenAlex.

  1. Article
  2. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

6 authors at 1 institution in 1 country.

M El-AhmarDepartment of General and Visceral Surgery, Helios Kliniken Schwerin, 19055, Schwerin, Germany. Mohamad.El-Ahmar@helios-gesundheit.de.ORCID http://orcid.org/0000-0001-7355-4125
F KochDepartment of General and Visceral Surgery, Helios Kliniken Schwerin, 19055, Schwerin, Germany.
A KöhlerDepartment of General and Visceral Surgery, Helios Kliniken Schwerin, 19055, Schwerin, Germany.
L MoikowDepartment of Anesthesiology, Helios Kliniken Schwerin, 19055, Schwerin, Germany.
M RistigDepartment of General and Visceral Surgery, Helios Kliniken Schwerin, 19055, Schwerin, Germany.
J-P RitzDepartment of General and Visceral Surgery, Helios Kliniken Schwerin, 19055, Schwerin, Germany.
Helios Hospital Schwerin · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposePlacement of an epidural catheter (EC) in colorectal resections is still recommended as a valid measure to achieve a low level of pain. However, EC is associated with increased invasiveness and with an increased risk of bladder emptying disorders and a decrease in blood pressure, which all relate to delayed mobilization. Preliminary data shows that EC placement may not be necessary for laparoscopic colon resections. The aim of this prospective study was to investigate how the omission of EC placement influences short-term postoperative outcomes in laparoscopic rectal resections.

methodsAll laparoscopic rectal resections occurring between 2013 and 2020 were prospectively examined. Resections from January 2013 to February 2018 (group A) were compared with resections from March 2018 to December 2020 (group B; after the internal change of the perioperative pain regime). In addition to EC placement, the other target parameters of our study were urinary catheter placement during the inpatient stay, postoperative pain > 3 days on a numerical rating scale (NRS), mobilization in the first 5 postoperative days, time until the first postoperative bowel movement, postoperative complications according to Clavien-Dindo, intermediate care unit stay (IMC stay) in days, and hospital length of stay in days.

resultsIn the entire study period, 221 laparoscopic rectal resections were performed: 122 in group A and 99 resections in group B. The frequency of EC placement and urinary catheter placement, postoperative IMC stay, and hospital length of stay was significantly lower in group B (p < 0.05). The postoperative mobilization of patients in group B was possible more quickly. There were no differences in the level of pain, time until the first postoperative bowel movement, and postoperative complications according to Clavien-Dindo.

conclusionOmission of EC placement in laparoscopic rectal resections led to faster mobilization, a shorter IMC stay, and a shorter hospital stay without increasing the pain level. Postoperative complications did not change when an EC was not placed. Therefore, routine EC placement in laparoscopic rectal resections is unnecessary.

Indexed as

LaparoscopyRectal NeoplasmsCathetersHumansLength of StayPostoperative ComplicationsPostoperative PainProspective StudiesTreatment OutcomeConvalescenceEpidural cathetersLaparoscopyRectal resections

Identifiers

PMID36001167
OpenAlexW4293171196

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.