Evidence map›Paper›PMID 39607440›Full record

SynthesisInternational journal of colorectal disease2024

Systematic review and meta-analysis comparing outcomes of multi-port versus single-incision laparoscopic surgery (SILS) in Hartmann's reversal.

Omar E S Mostafa, Shafquat Zaman, William Beedham, Georgios Kakaniaris, Najam Husain, Lalit Kumar, Akinfemi Akingboye, Peter Waterland

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

Synthesis in International journal of colorectal disease, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

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

5 citing papers in PubMed.

  1. Two-portWorld journal of gastrointestinal surgery · 2026
    Article
  2. Article
  3. Article
  4. Review
  5. Article
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

8 authors.

Omar E S Mostafa *Department of General and Colorectal Surgery, Russells Hall Hospital, Dudley Group NHS Foundation Trust, Dudley, UK.
Shafquat Zaman *Department of General and Colorectal Surgery, Queen's Hospital Burton, University Hospital of Derby and Burton NHS Foundation Trust, Derby, UK. s.zaman@bham.ac.uk.
William BeedhamDepartment of General and Colorectal Surgery, Russells Hall Hospital, Dudley Group NHS Foundation Trust, Dudley, UK.
Georgios KakaniarisDepartment of General and Colorectal Surgery, Queen's Hospital Burton, University Hospital of Derby and Burton NHS Foundation Trust, Derby, UK.
Najam HusainDepartment of General and Colorectal Surgery, Queen's Hospital Burton, University Hospital of Derby and Burton NHS Foundation Trust, Derby, UK.
Lalit KumarDepartment of General and Colorectal Surgery, Russells Hall Hospital, Dudley Group NHS Foundation Trust, Dudley, UK.
Akinfemi AkingboyeDepartment of General and Colorectal Surgery, Russells Hall Hospital, Dudley Group NHS Foundation Trust, Dudley, UK.
Peter WaterlandDepartment of General and Colorectal Surgery, Russells Hall Hospital, Dudley Group NHS Foundation Trust, Dudley, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundColostomy formation as part of the Hartmann's procedure is often performed during emergency surgery as a damage limitation measure where attempts at bowel anastomosis and continuity are contraindicated. Hartmann's reversal (HR) remains challenging and can be attempted through open surgery and various minimally invasive techniques (laparoscopic and robotic platforms). We aimed to analyse outcomes of conventional multi-port laparoscopy (CL) versus single-incision approach (SILS) in patients undergoing HR.

methodsA comprehensive online search of various databases was conducted in accordance with PRISMA guidelines including Medline, PubMed, Embase, and Cochrane. Comparative studies of patients undergoing CL and SILS for HR were included. Analysed primary outcomes were total operative time and mortality rate. Secondary outcomes included post-operative complications, length of hospital stay, risk of visceral injury intra-operatively, and re-operation rate. Combined overall effect sizes were calculated using the random-effects model, and the Newcastle-Ottawa Scale (NOS) was used to assess bias.

resultsTwo observational studies matching our inclusion criteria with a total of 160 patients (SILS 100 vs. CL 60) were included. Statistical difference was observed for one outcome measure: operative duration (MD - 44.79 CI - 65.54- - 24.04, P < 0.0001). No significant difference was seen in mortality rate (OR 1.66 CI 0.17-16.39, P = 0.66), overall post-operative complications (OR 0.60 CI 0.28-1.32, P = 0.20), length of stay (MD - 0.22 CI - 4.25-3.82, P = 0.92), Clavien-Dindo III + complications (OR 0.61 CI 0.15-2.53, P = 0.50), risk of visceral injury (OR 1.59 CI 0.30-8.31, P = 0.58), and re-operation rates (OR 0.73 CI 0.08-6.76, P = 0.78).

conclusionAccounting for study limitations, the SILS procedure seems to be quicker with non-inferior outcomes compared with the conventional multi-port approach. This may lead to better patient satisfaction and cosmesis and potentially reduce the risk of future incisional hernia occurrence. However, well-designed, randomised studies are needed to draw more robust conclusions and recommendations.

Indexed as

LaparoscopyPostoperative ComplicationsColostomyHumansLength of StayOperative TimePublication BiasReoperationTreatment OutcomeColostomy reversalLaparoscopyMulti-portSILS

Identifiers

PMID39607440
PMCPMC11604776

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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.