Background
Methods
Systematic literature search
Study selection
Data extraction and quality assessment
Results
Study selection process
Description of systematic reviews
Study | Inclusion criteria | Data bases, (search period), number of included studies |
---|---|---|
Golub 1998 [13] | Comparison between LA and OA in adults formally, RCT, published in English | Medline (09/1992 – 07/1997), 16 studies included |
Meynaud-Kraemer 1999 [16] | Comparison between LA and OA in adults, RCT, published in English/ French/ German | Medline (search period not reported), 8 studies included |
Temple 1999 [19] | Patients with preoperative diagnosis of acute appendicitis comparison between LA and OA, RCT (random allocation of patients into LA or OA), published in English, LA intended to be therapeutic rather than diagnostic, ≥ 80% of randomized patients were followed up for at least one of the main outcomes | Medline (01/1990 - 03/1997), 12 studies included |
Bennett 2007 [12] | Comparison between LA and OA for acute appendicitis, RCT, allocation concealment, published in English peer-reviewed journal, not as abstract reported | Cochrane Library, Medline, Embase, (1995 – 05/2006), 33 studies included |
Li 2010 [14] | Comparison between LA and OA, RCT, published in English, desirable outcome reported | Medline, Embase, Central (01/1990-12/2009), 44 studies included |
Liu 2010 [15] | Comparison between LA and OA, ≥9 years old, not pregnant, no drug abuse, no psychiatric disorder, RCT, no language restriction | Medline, Embase, Cochrane Library (01/1992 – 01/2008), 16 studies included |
Sauerland 2010 [18] | Comparison between LA and OA in adults or children with symptoms and signs of acute appendicitis, RCT, adequate concealment of allocations, no language restriction, authors of an abstract were requested for details and had to provide full information on their trial, more than 50% appendix specimens without histological signs of inflammation | Medline, Embase, Cochrane Library, Lilacs, CNKI, SciSearch Cochrane/Medline (- 15/04/2010) remaining databases (-08/2009), 67 studies included |
Wei 2011 [20] | Comparison between LA and OA, RCT, published in English, most recent article from the same institution when several studies reporting the same patients, at least four variables of interest could derived from the published results, no variations on the standard laparoscopic technique including laparoscope-assisted or single-trocar appendectomy | Medline, Embase, Current Contents (01/1992 – 02/2010), 25 studies included |
Ohtani 2012 [17] | Comparison between LA and OA, RCT, abstracts excluded (only included if full text was published), published in English, at least one of the outcome measures mentioned | Medline, Embase, Central, Science Citation Index (01/1990 – 02/2012), 39 studies included |
AMSTAR ratings for the reviews
AMSTAR criteria | Golub 1998 | Meynaud-Kraemer 1999 | Temple 1999 | Benett 2007 | Li 2010 | Liu 2010 | Sauerland 2010 | Wei 2011 | Ohtani 2012 |
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A priori design
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o
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o
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+
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o
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o
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o
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o
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o
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Duplicate study selection and extraction
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-
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o
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o
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Literature search comprehensive
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-
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-
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-
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+
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+
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Status of publication used as criteria
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Excluded/included list provided
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-
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-
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-
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-
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Study characteristics provided
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+
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-
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Quality assessed/presented
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-
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Quality impacted conclusions
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Heterogeneity tested before combining
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Publication bias assessed
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o
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-
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-
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-
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+
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-
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Conflict stated
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-
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-
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-
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-
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+
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-
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-
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Overview of primary and secondary outcomes
Golub 1998 | Meynaud-Kraemer 1999 | Temple 1999 | Bennett 2007 | Li 2010 | Liu 2010 | Sauerland 2010 | Wei 2011 | Ohtani 2012 | |
---|---|---|---|---|---|---|---|---|---|
Primary outcomes
| |||||||||
pain on postoperative day 1 [WMD, 95%-CI] | - | - | - | LA (5) [-0.8, -1.84;0.25] | LA* (8) [-0,7, -1.22;-0.19] | - | LA* (15) [-0.82, -1.14;-0.49] | - | - |
wound infections [OR, 95%-CI] | LA* (16) [0.3, 0.19;0.47]† | LA* (8) [0.33, 0.18;0.61]† | LA* (10) [0.4, 0.24;0.69]† | LA* (25) [0.52, 0.39;0.70] | LA* (31) [0.45, 0.34;0.59]† | LA* (13) [0.51, 0.36;0.73]† | LA* (50) [0.43, 0.34;0.54]† | LA* (20) [-, 0.3;0.56]† | LA* (32) [0.46, 0.34;0.62]† |
intraabdominal abscesses [OR, 95%-CI] | OA (15) [2.2, 0.88;6.64]† | - | OA (6) [1.94, 0.68;5.58]† | OA* (25) [2.29, 1.48;3.53]† | OA* (17) [1.56, 1.01;2.43]† | - | OA* (45) [1.87, 1.19;2.93]† | OA (12) [-, 0.93;2.14]† | - |
mortality | - | - | - | - | - | LA (7) | - | - | - |
[OR, 95%-CI] | [0.97, 0.29;3.25]† | ||||||||
secondary outcomes
| |||||||||
duration of surgery [WMD, 95%-CI] | OA* (16) [18.3, -;-] | - | OA* (8) [18.1, 12.87;23.15] | OA* (22) [14.61, 9.04;20.19] | OA* (36) [12.35, 7.99;16.72] | OA* (8) [7.6, 6.03;9.17] | OA* (38) [10,24 5.51;14.97] | OA* (25) [10.71, 6.76;14.66] | OA* (36) [13.12, 9.72;16.51] |
overall conversion rate {range} | 9.7% (14) {0%-20%} | - | 11% (-) {5%-20%} | - | - | - | - | - | - |
length of hospital stay [WMD, 95%-CI] | LA* (14) [-0,61, -;-] | - | LA (8) [-0.16, -0.44;0.15]† | LA* (18) [-0.62, -1.05;-0.18] | LA* (32) [-0.6, -0.85;-0.36] | LA* (8) [-0.82, -0.93;-0.7] | LA* (34) [-1.13, -1.51;-0.74] | LA* (23) [-0.68, -1.02;-0.35] | LA* (33) [-0.79, -1.06;-0.52] |
in-hospital costs (including surgery costs) [OR, 95%-CI] | - | - | - | - | - | - | OA* (6) [1.32, 0.42;2.22] | - | OA (7) [-] |
time until return to work [WMD, 95%-CI] | - | - | - | - | - | - | LA (8) [-1.6, -5.22;2.02] | LA* (11) [-3.09, -5.22;-0.97] | LA* (10) [-3.18, -5.09;-1.27] |
Citation matrix
Systematic review included RCTs | Golub 1998 | Meynaud-Kraemer 1999 | Temple 1999 | Bennett 2007 | Li 2010 | Liu 2010 | Sauerland 2010 | Wei 2011 | Ohtani 2012 |
---|---|---|---|---|---|---|---|---|---|
N = 16 | N = 8 | N = 12 | N = 33 | N = 44 | N = 16 | N = 67 | N = 25 | N = 39 | |
DeWilde 1991 | x | ||||||||
Attwood 1992 | x | x | x | x | x | x | |||
Kum 1993 | x | x | eFU | x | x | x | x | ||
Olsen 1993 | x | ||||||||
Tate 1993 | x | x | x | x | x | x | x | ||
Hebebrand 1994 | x | x | |||||||
Eichen 1994 | x | ||||||||
Frazee 1994 | x | x | x | x | x | x | x | x | |
Jadallah 1994 | x | ||||||||
Rohr 1994 | x | eFT | eAR | ||||||
Martin 1995 | x | x | x | x | x | x | x | x | x |
Ortega 1995 | x | x | x | x | x | x | x | x | |
Settmacher 1995 | x | ||||||||
Cox 1996 | x | x | x | x | x | x | x | x | |
Hansen 1996 | x | x | x | x | x | x | x | x | |
Hart 1996 | x | x | x | x | x | x | |||
Lejus 1996 | x | x | x | x | |||||
Mutter 1996 | x | x | x | x | x | x | x | ||
Williams 1996 | x | x | x | x | x | x | x | x | |
Pozo 1996 | x | ||||||||
Yin 1996 | x | x | |||||||
Kazemier 1997 | x | x | x | x | x | x | x | ||
Laine 1997 | x | x | x | x | x | ||||
Macarulla 1997 | x | x | x | x | x | x | |||
Minné 1997 | x | x | x | x | x | x | |||
Reiertsen 1997 | x | eFU | x | x | x | x | |||
Schippers 1997 | x | ||||||||
Sezeur 1997 | x | ||||||||
Yeung 1997 | x | ||||||||
Heikkinen 1998 | x | x | x | x | x | ||||
Stare 1998 | x | ||||||||
Sun 1998 | x | ||||||||
Zhang 1998 | eFT | x | |||||||
Klingler 1998 | x | x | x | x | |||||
Witten 1998 | x | ||||||||
Barth 1999 | xUS | x | |||||||
Bauwens 1999 | x | ||||||||
Hellberg 1999 | x | x | x | x | x | x | |||
Hellberg 2001 | era | x | |||||||
Enochsson 2001 | eSA | era | x | ||||||
Kald 1999 | x | x | x | ||||||
Perner 1999 | x | ||||||||
Özmen 1999 | x | x | x | x | |||||
Navarra 2000 | x | ||||||||
Nordentoft 2000 | x | x | x | ||||||
Huang 2001 | x | x | x | x | x | ||||
Helmy 2001 | x | x | x | x | |||||
Larsson 2001 | eDL | eDL | x | ||||||
Lavonius 2001 | x | x | x | ||||||
Long 2001 | x | x | x | x | x | x | |||
Pedersen 2001 | x | x | x | x | x | x | |||
Al-Mulhim 2002 | x | x | x | x | |||||
Little 2002 | x | x | |||||||
Bruwer 2003 | x | x | x | x | |||||
Karadayi 2003 | x | x | x | ||||||
Milewczyk 2003 | x | x | eAC | x | x | ||||
Vallribera 2003 | x | ||||||||
van Dalen 2003 | eDL | eDL | x | ||||||
Oka 2004 | x | eNR | x | x | |||||
Ignacio 2004 | x | x | x | x | x | x | |||
Lintula 2001 | era | x | x | x | |||||
Lintula 2002 | era | x | |||||||
Lintula 2004 | x | x | x | ||||||
Katkhouda 2005 | x | x | x | x | x | x | |||
Olmi 2005 | x | x | x | x | |||||
Moberg 2005 | x | x | x | x | x | x | |||
Kaiser 2006 | x | ||||||||
Ricca 2007 | x | x | |||||||
Tzovaras 2007 | x | x | x | ||||||
Bolla 2008 | x | ||||||||
Moirangthem 2008 | x | x | |||||||
Kehagias 2008 | x | ||||||||
Kaplan 2009 | x | x | |||||||
Kehagias 2009 | x | ||||||||
Simon 2009 | x | x | |||||||
Wei 2010 | x | x | x | x | |||||
Tzovaras 2010 | x | ||||||||
Kouhia 2010 | x | ||||||||
Shirazi 2010 | x | ||||||||
Khalil 2011 | x | ||||||||
Clarke 2011 | x |