Gang Tang, Jumei Wang, Rui Chen, Jie Zhang, Rongxing Zhou
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Mean difference (MD) or odds ratios (OR) and 95% confidence intervals were calculated.</p><p><strong>Results: </strong>Fifteen studies totaling 33,596 patients were included. There were no differences between nighttime and daytime appendectomy for rates of overall postoperative complications (OR 0.93, 95% CI 0.87, 1.00, 14 studies), mortality (OR 1.70, 95% CI 0.37, 7.88, 7 studies), intraoperative complications (OR 0.88, 95% CI 0.08, 9.86; 2 studies), reoperation (OR 0.39, 95% CI 0.06, 2.55; 3 studies) and readmission (OR 0.86, 95% CI 0.65, 1.13; I<sup>2</sup> = 0%, 5 studies). However, the conversion to laparotomy risks (OR 1.92, 95% CI 1.12, 3.29; 6 studies) among patients who underwent appendectomy during nighttime was significantly elevated compared to daytime.</p><p><strong>Conclusions: </strong>There was no increased risk or difference in postoperative mortality and complication rates associated with nighttime compared with daytime appendectomy. 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引用次数: 0
摘要
背景:阑尾炎是全球最常见的急性外科疾病之一:阑尾炎是全球最常见的急性外科疾病之一。然而,夜间阑尾切除术与患者发病率和死亡率之间的关系尚不清楚。本研究旨在比较夜间与白天阑尾切除术的结果:方法:检索了截至 2024 年 3 月 26 日(2024 年 7 月 1 日更新)的 PubMed、Embase、Cochrane Library 和 Web of Science 数据库。主要结果为术后并发症和死亡率。次要结果包括术中并发症、再次手术、再次入院、转为开腹手术、住院时间和手术时间。计算了平均差(MD)或几率比(OR)以及 95% 的置信区间:共纳入了 15 项研究,共计 33,596 名患者。在总体术后并发症发生率(OR 0.93,95% CI 0.87,1.00,14 项研究)、死亡率(OR 1.70,95% CI 0.37,7.88,7 项研究)、术中并发症(OR 0.88,95% CI 0.08,9.86;2 项研究)、再次手术(OR 0.39,95% CI 0.06,2.55;3 项研究)和再次入院(OR 0.86,95% CI 0.65,1.13;I2 = 0%,5 项研究)。然而,与白天相比,在夜间接受阑尾切除术的患者转为开腹手术的风险(OR 1.92,95% CI 1.12,3.29;6 项研究)显著升高:结论:与日间阑尾切除术相比,夜间阑尾切除术的术后死亡率和并发症发生率没有增加的风险或差异。结论:夜间阑尾切除术与白天阑尾切除术相比,术后死亡率和并发症发生率没有增加的风险或差异。
Daytime versus nighttime appendectomy in term of complications and clinical outcomes: a meta-analysis.
Background: Appendicitis is one of the most common acute surgical conditions globally. However, the association between nighttime appendectomy and patients' morbidity and mortality is unclear. This study aims to compare outcomes following nighttime versus daytime appendectomy.
Methods: The PubMed, Embase, Cochrane Library, and Web of Science databases up to March 26, 2024 (updated on July 1, 2024) were searched. The primary outcomes were postoperative complications and mortality. Secondary outcomes included intraoperative complications, reoperation, readmission, conversion to laparotomy, hospital stay and operation time. Mean difference (MD) or odds ratios (OR) and 95% confidence intervals were calculated.
Results: Fifteen studies totaling 33,596 patients were included. There were no differences between nighttime and daytime appendectomy for rates of overall postoperative complications (OR 0.93, 95% CI 0.87, 1.00, 14 studies), mortality (OR 1.70, 95% CI 0.37, 7.88, 7 studies), intraoperative complications (OR 0.88, 95% CI 0.08, 9.86; 2 studies), reoperation (OR 0.39, 95% CI 0.06, 2.55; 3 studies) and readmission (OR 0.86, 95% CI 0.65, 1.13; I2 = 0%, 5 studies). However, the conversion to laparotomy risks (OR 1.92, 95% CI 1.12, 3.29; 6 studies) among patients who underwent appendectomy during nighttime was significantly elevated compared to daytime.
Conclusions: There was no increased risk or difference in postoperative mortality and complication rates associated with nighttime compared with daytime appendectomy. However, future studies should assess the reasons for higher conversion rates during the night.
期刊介绍:
The International Journal of Colorectal Disease, Clinical and Molecular Gastroenterology and Surgery aims to publish novel and state-of-the-art papers which deal with the physiology and pathophysiology of diseases involving the entire gastrointestinal tract. In addition to original research articles, the following categories will be included: reviews (usually commissioned but may also be submitted), case reports, letters to the editor, and protocols on clinical studies.
The journal offers its readers an interdisciplinary forum for clinical science and molecular research related to gastrointestinal disease.