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Pediatric Surgery International
Published in: Pediatric Surgery International 2/2018

01-02-2018 | Original Article

Laparoscopy or laparotomy for adhesive bowel obstruction in children: a systematic review and meta-analysis

Authors: Hiromu Miyake, Shogo Seo, Agostino Pierro

Published in: Pediatric Surgery International | Issue 2/2018

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Abstract

Purpose

Adhesive small bowel obstruction (ASBO) is one of the most important cause of postoperative morbidity in children who underwent abdominal surgery. Laparoscopic management for ASBO in pediatric patients has been reported. However, its safety and efficacy has not been evaluated in details. The aim of this study is to compare the outcomes of laparoscopy and laparotomy for the treatment of ASBO in children.

Methods

A systematic review and meta-analysis were performed following the Cochrane Handbook for systematic reviews of intervention and the preferred reporting item for systematic reviews and meta-analysis (PRISMA) and a protocol registered in PROSPERO (CRD42017067914). The primary outcome was the number of intraoperative and postoperative complications. The secondary outcome was length of hospital stay. The risk of bias in non-randomized studies of interventions (ROBINS-I) tool was used to assess the risk of bias. Quality of evidence was summarized using the grades of recommendation, assessment, development and evaluation (GRADE) approach.

Results

We identified three observational studies and no randomized controlled trials. The meta-analysis was done only for the primary outcome. Complications were significantly fewer after laparoscopy compared to laparotomy (Odds ratio = 0.51; 95% CI 0.40–0.66; p < 0.01; I 2: 0%). The overall risk of bias was considered serious.

Conclusions

Our results, based on observational studies, indicate that laparoscopy for ASBO was associated with less postoperative complications compared to conventional laparotomy. However, the quality of evidence is very low. A well-controlled study is needed to assess the efficacy of laparoscopy for pediatric patients with ASBO.
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Metadata
Title
Laparoscopy or laparotomy for adhesive bowel obstruction in children: a systematic review and meta-analysis
Authors
Hiromu Miyake
Shogo Seo
Agostino Pierro
Publication date
01-02-2018
Publisher
Springer Berlin Heidelberg
Published in
Pediatric Surgery International / Issue 2/2018
Print ISSN: 0179-0358
Electronic ISSN: 1437-9813
DOI
https://doi.org/10.1007/s00383-017-4186-0

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