SynthesisLangenbeck's archives of surgery2025
Diaphragmatic stripping versus full-thickness diaphragmatic resection in cytoreductive surgery: a meta-analysis of the current evidence.
Synthesis in Langenbeck's archives of surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
What it found
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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.
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.
Who cites it
3 citing papers in PubMed.
- Controlled capnothorax creation for stapled diaphragm resection: a safe maneuver for en-bloc liver and frenic resection without diaphragm opening.Surgical endoscopy · 2026Article
- When it Comes to Complete Gross Resection, it Isn't Complicated: Evaluating Types of Diaphragmatic Surgery in Advanced Ovarian Cancer.Annals of surgical oncology · 2026Article
- Reflections on the role of diaphragmatic resection techniques in cytoreductive surgery: indications, outcomes, and unresolved questions.Langenbeck's archives of surgery · 2025Article
Corrections and comments
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThe primary objective was to compare the intra- and postoperative outcomes of diaphragmatic stripping versus full-thickness diaphragmatic resection in patients with peritoneal carcinomatosis who underwent cytoreductive surgery.
methodsAccording to the PRSIMA guidelines, a comprehensive literature search was conducted for studies comparing postoperative pulmonary complications as well as intra- and postoperative outcomes of diaphragmatic stripping versus full-thickness diaphragmatic resection in patients with peritoneal carcinomatosis necessitating cytoreductive surgery. Data from eligible studies were extracted, qualitatively assessed, and included in a meta-analysis. Odds ratios (ORs) and standardized mean differences (SMDs) with 95 per cent confidence intervals were calculated.
resultsTen studies with 1325 patients were included in this meta-analysis. Diaphragmatic stripping was associated with lower incidence of pleural effusion (OR 0.47, 95% CI 0.35-0.63, p < 0.00001) and pneumothorax (OR 0.52, 95% CI 0.35-0.78, p = 0.002), less severe postoperative complications (Clavien-Dindo Grade ≥ 3) (OR 0.43, 95% CI 0.30-0.63, p < 0.0001), and shorter duration of surgery (SMD -0.31, 95% CI -0.54 - -0.08, p = 0.007). No significant differences were observed in postoperative subdiaphragmatic abscess occurrence, intraoperative blood loss, hospital- and ICU-stay, and 90-day mortality.
conclusionsDiaphragmatic stripping leads to a significantly lower rate of postoperative pulmonary and severe complications compared to diaphragmatic full-thickness resection, while oncological outcomes do not appear to be worse. Larger trials with standardized study protocols and long-term survival data are needed to validate the results presented here.
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