Goran Augustin1, Matija Boric2, Ognjen Barcot3, Livia Puljak4. 1. Department of Surgery, University Hospital Centre Zagreb, Zagreb, Croatia. 2. Department of Surgery, University Hospital Centre Split, Spinčićeva 1, 21000, Split, Croatia. matija.boric.st@gmail.com. 3. Department of Surgery, University Hospital Centre Split, Spinčićeva 1, 21000, Split, Croatia. 4. Center for Evidence-Based Medicine and Health Care, Catholic University of Croatia, Zagreb, Croatia.
Abstract
OBJECTIVES: Our study aimed to explore the discrepancy of results between overlapping systematic reviews (SRs) of laparoscopic appendectomy (LA) versus open appendectomy (OA) for suspected appendicitis during pregnancy. METHODS: MEDLINE, Embase, and Cochrane Database of Systematic Reviews (CDSR) were searched for SRs published from January 1, 2017 to September 10, 2019. SRs and meta-analyses (MA) that compared outcomes of LA versus OA during pregnancy were used. Data regarding the methodology of SR/MA, included studies, efficacy and safety outcomes were extracted. SR quality was analysed with AMSTAR 2. RESULTS: Four SRs were found, published between April 2018 and April 2019. These reviews included a variety of primary studies, ranging from 17 to 22, and number of included patients varied from 4694 to 6276. A total of 13 outcomes were analyzed. Nine outcomes were included in more than one review; among them, discrepancies between summary effect sizes in meta-analyses were found in four outcomes: preterm birth, Apgar score at 5 min, length of stay in hospital, and wound infection rates. One primary study, which included more than half of the total number of patients in analyzed reviews, showed a predominant effect on the outcome for fetal loss. All four SRs had critically low methodological quality. CONCLUSIONS: The outcomes of LA versus OA for suspected appendicitis in pregnancy represented in four recent SRs do not provide consistent results. Such uncertainties require new, high-quality primary and secondary evidence on this topic.
OBJECTIVES: Our study aimed to explore the discrepancy of results between overlapping systematic reviews (SRs) of laparoscopic appendectomy (LA) versus open appendectomy (OA) for suspected appendicitis during pregnancy. METHODS: MEDLINE, Embase, and Cochrane Database of Systematic Reviews (CDSR) were searched for SRs published from January 1, 2017 to September 10, 2019. SRs and meta-analyses (MA) that compared outcomes of LA versus OA during pregnancy were used. Data regarding the methodology of SR/MA, included studies, efficacy and safety outcomes were extracted. SR quality was analysed with AMSTAR 2. RESULTS: Four SRs were found, published between April 2018 and April 2019. These reviews included a variety of primary studies, ranging from 17 to 22, and number of included patients varied from 4694 to 6276. A total of 13 outcomes were analyzed. Nine outcomes were included in more than one review; among them, discrepancies between summary effect sizes in meta-analyses were found in four outcomes: preterm birth, Apgar score at 5 min, length of stay in hospital, and wound infection rates. One primary study, which included more than half of the total number of patients in analyzed reviews, showed a predominant effect on the outcome for fetal loss. All four SRs had critically low methodological quality. CONCLUSIONS: The outcomes of LA versus OA for suspected appendicitis in pregnancy represented in four recent SRs do not provide consistent results. Such uncertainties require new, high-quality primary and secondary evidence on this topic.
Authors: Jianzhou Yang; Shi Wu Wen; Daniel Krewski; Daniel J Corsi; Mark Walker; Donald Mattison; Ryan Moog; Doug McNair; Huiping Huang; Guihua Zhuang Journal: PLoS One Date: 2021-12-13 Impact factor: 3.240
Authors: Livia Puljak; Elena Parmelli; Matteo Capobussi; Marien Gonzalez-Lorenzo; Alessandro Squizzato; Lorenzo Moja; Nicoletta Riva Journal: Front Res Metr Anal Date: 2022-04-15