PURPOSE: The incidence of surgical site infections (SSI) following laparoscopy in the pediatric population remains unknown. Our aim was to determine whether infants and children undergoing laparoscopy are at lower risk of developing SSI than those undergoing laparotomy. METHODS: With a defined search strategy, comparative studies reporting the incidence of SSI following laparoscopy or laparotomy in infants and children were identified. Using RevMan 5.3, we conducted a meta-analysis on the incidence of SSI: 1) in all patients; 2) after appendectomy; 3) after clean intra-abdominal surgery (CIS). RESULTS: Of 13,938 titles/abstracts screened, 134 were comparative studies (570,600pts), including 12 randomized controlled trials (RCT). Most studies (n=65; 550,787pts; 97%) were on appendectomy. Overall: the SSI incidence following laparoscopy was 1.3%. SSI incidence was lower after laparoscopy than after laparotomy (p<0.00001). This was confirmed when assessing RCTs alone, where the SSI incidence was 1.2% following laparoscopy versus 3.7% following laparotomy (p<0.05, Figure). Appendectomy: the SSI incidence was lower following laparoscopy (1.1%) than open appendectomy (1.4%; p<0.00001). CIS: laparoscopy was associated with a lower SSI incidence (2.2%) compared to laparotomy (3.5%; p<0.00001). CONCLUSIONS: Infants and children treated by laparoscopy are at lower risk of SSI than those undergoing laparotomy. This is observed following various procedures, including appendectomy, and is supported by a high level of evidence.
Laparoscopy Reduces the Risk of Surgical Site Infections in Infants and Children: A Systematic Review and Meta-Analysis
Giuseppe Lauriti;Gabriele Lisi;Pierluigi Lelli Chiesa;
2018-01-01
Abstract
PURPOSE: The incidence of surgical site infections (SSI) following laparoscopy in the pediatric population remains unknown. Our aim was to determine whether infants and children undergoing laparoscopy are at lower risk of developing SSI than those undergoing laparotomy. METHODS: With a defined search strategy, comparative studies reporting the incidence of SSI following laparoscopy or laparotomy in infants and children were identified. Using RevMan 5.3, we conducted a meta-analysis on the incidence of SSI: 1) in all patients; 2) after appendectomy; 3) after clean intra-abdominal surgery (CIS). RESULTS: Of 13,938 titles/abstracts screened, 134 were comparative studies (570,600pts), including 12 randomized controlled trials (RCT). Most studies (n=65; 550,787pts; 97%) were on appendectomy. Overall: the SSI incidence following laparoscopy was 1.3%. SSI incidence was lower after laparoscopy than after laparotomy (p<0.00001). This was confirmed when assessing RCTs alone, where the SSI incidence was 1.2% following laparoscopy versus 3.7% following laparotomy (p<0.05, Figure). Appendectomy: the SSI incidence was lower following laparoscopy (1.1%) than open appendectomy (1.4%; p<0.00001). CIS: laparoscopy was associated with a lower SSI incidence (2.2%) compared to laparotomy (3.5%; p<0.00001). CONCLUSIONS: Infants and children treated by laparoscopy are at lower risk of SSI than those undergoing laparotomy. This is observed following various procedures, including appendectomy, and is supported by a high level of evidence.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
