SynthesisWorld journal of surgery2026
Operative Versus Selective Non-operative Management in Adult Penetrating Abdominal Trauma With Bowel or Omental Evisceration: A Systematic Review and Meta-Analysis.
Synthesis in World journal of surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled 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.
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
1 citing paper in PubMed, 1 synthesis or guideline pooled it.
Corrections and comments
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Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPenetrating abdominal trauma with bowel or omental evisceration has traditionally mandated exploratory laparotomy due to perceived high risk of intra-abdominal injury. Selective nonoperative management (SNOM) has gained acceptance in stable patients, but evidence specific to evisceration remains limited and controversial.
objectiveTo compare outcomes of operative management versus SNOM in adults with penetrating abdominal trauma and documented evisceration.
methodsSystematic review conducted per PRISMA 2020 guidelines. Databases searched were as follows: PubMed, Scopus, Wits Summon, and Google Scholar (1980-2025). Inclusion were as follows: adults ≥ 18 years, penetrating (stab/gunshot) trauma, documented bowel/omental evisceration, operative versus SNOM comparison, and outcomes (mortality, missed injuries, delayed therapeutic laparotomy, complications, and length of stay). Risk of bias via Newcastle-Ottawa Scale; evidence certainty via GRADE. Random-effects meta-analysis performed where feasible PROSPERO registration number: (CRD420261345559).
resultsFrom 292 records, 152 remained after deduplication; 47 full texts assessed; 20 studies included in qualitative synthesis; and 13 in meta-analysis. SNOM significantly reduced nontherapeutic laparotomy (pooled OR 0.61, 95% CI 0.46-0.80; I
conclusionsIn hemodynamically stable patients with penetrating abdominal trauma and evisceration, SNOM appears safe and preferable in selected cases reducing unnecessary laparotomies without compromising outcomes. Prospective trials are needed to refine indications.
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