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Abdominal laparoscopic surgery reduces surgical infections by 70-80% compared with open surgery in obese patients
Shabanzadeh DM, Sorensen LT. Laparoscopic surgery compared with open surgery decreases surgical site infection in obese patients: a systematic review and meta-analysis. Ann Surg. 2012;256:934-45.
What is the effect of laparoscopic surgery on surgical infections in obese patients?
Laparoscopic or minimally invasive surgery uses a lighted tube (laparoscope) with a tiny camera and specialized tools. The tube is inserted via small incisions (cuts) in the abdomen. Incisions are between 0.5 and 1.5 cm.
Traditional or open surgery uses larger incisions.
In general surgery, obesity increases the chances for surgical site infection.
For non-obese patients, laparoscopic surgery has fewer post-surgery complications and a shorter hospital stay than open surgery.
How the review was done
This summary is based on a systematic review of 8 randomized controlled trials and 36 observational studies of bariatric (weight-loss) and non-bariatric surgery.
RCTs included 615 obese patients. 7 studied weight-loss surgery and 1 appendix removal. They were published between 1999 and 2011.
Observational studies involved 58,755 patients. They included various surgeries: bariatric, hernia, gall bladder, appendix, colon and large bowel, and general. They were published between 1992 and 2011.
What the researchers found
Results from randomized controlled trials
- Laparoscopic surgery reduced surgical site infections by about 80%.
Results from observational studies
- Laparoscopic surgery reduced surgical site infections by about 70%.
Quality of evidence
- All trials were high quality. However, none was designed expressly to assess differences in surgical site infections between laparoscopic and open surgery.
- There was a large variation of treatment effects in the observational studies. The most typical flaw was a risk of selection bias.
Laparoscopic surgery in obese patients reduces infections in the surgical area by 70-80% compared with open surgery for general abdominal surgical procedures.
Studies where the treatment that each person receives is beyond the control of the researcher.
Randomized controlled trials
Studies where people are assigned to one of the treatments purely by chance.
Possibility of errors in choosing individuals or groups to take part in a research study.
A comprehensive evaluation of the available research evidence on a particular topic.
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