Song SR, Liu YY, Guan YT, Li RJ, Song L, Dong J, Wang PG. Timing of surgical operation for patients with intra-abdominal infection: A systematic review and meta-analysis. World J Gastrointest Surg 2023; 15(10): 2320-2330 [PMID: 37969709 DOI: 10.4240/wjgs.v15.i10.2320]
Corresponding Author of This Article
Pei-Ge Wang, Doctor, Chief Physician, Director, Professor, Department of Emergency Surgery, The Affiliated Hospital of Qingdao University, No. 16 Jiangsu Road, Qingdao 266000, Shandong Province, China. wpgzyz@163.com
Research Domain of This Article
Infectious Diseases
Article-Type of This Article
Meta-Analysis
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Surg. Oct 27, 2023; 15(10): 2320-2330 Published online Oct 27, 2023. doi: 10.4240/wjgs.v15.i10.2320
Timing of surgical operation for patients with intra-abdominal infection: A systematic review and meta-analysis
Shu-Rui Song, Yang-Yang Liu, Yu-Ting Guan, Ruo-Jing Li, Lei Song, Jing Dong, Pei-Ge Wang
Shu-Rui Song, Yang-Yang Liu, Yu-Ting Guan, Ruo-Jing Li, Lei Song, Pei-Ge Wang, Department of Emergency Surgery, The Affiliated Hospital of Qingdao University, Qingdao 266000, Shandong Province, China
Jing Dong, Medical Complex Building, Qingdao University, Qingdao 266071, Shandong Province, China
Author contributions: Wang PG and Dong J designed the review; Song SR reviewed the manuscript; Liu YY, Guan YT, Li RJ, and Song L participated in the design and drafting of this manuscript; Wang PG and Dong J performed a critical review of the original draft of the manuscript; All authors have read and approved the final manuscript.
Supported byTaishan Scholar Foundation of Shandong Province, No. 2018092901.
Conflict-of-interest statement: All the authors report having no relevant conflicts of interest for this article.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Pei-Ge Wang, Doctor, Chief Physician, Director, Professor, Department of Emergency Surgery, The Affiliated Hospital of Qingdao University, No. 16 Jiangsu Road, Qingdao 266000, Shandong Province, China. wpgzyz@163.com
Received: March 2, 2023 Peer-review started: March 2, 2023 First decision: May 16, 2023 Revised: June 4, 2023 Accepted: August 21, 2023 Article in press: August 21, 2023 Published online: October 27, 2023
Abstract
BACKGROUND
Intra-abdominal infections (IAIs) is the most common type of surgical infection, with high associated morbidity and mortality rates. In recent years, due to the use of antibiotics, various drug-resistant bacteria have emerged, making the treatment of abdominal infections more challenging. Early surgical exploration can reduce the mortality of patients with abdominal infection and the occurrence of complications. However, available evidence regarding the optimal timing of IAI surgery is still weak. In study, we compared the effects of operation time on patients with abdominal cavity infection and tried to confirm the best timing of surgery.
AIM
To assess the efficacy of early vs delayed surgical exploration in the treatment of IAI, in terms of overall mortality.
METHODS
A systematic literature search was performed using PubMed, EMBASE, Cochrane Central Register of Controlled Trials, Ovid, and ScienceDirect. The systematic review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-analyses method. Based on the timing of the surgical operation, we divided the literature into two groups: Early surgery and delayed surgery. For the early and delayed surgery groups, the intervention was performed with and after 12 h of the initial surgical intervention, respectively. The main outcome measure was the mortality rate. The literature search was performed from May 5 to 20, 2021. We also searched the World Health Organization International Clinical Trials Registry Platform search portal and ClinicalTrials.gov on May 20, 2021, for ongoing trials. This study was registered with the International Prospective Register of Systematic Reviews.
RESULTS
We identified nine eligible trial comparisons. Early surgical exploration of patients with IAIs (performed within 12 h) has significantly reduced the mortality and complications of patients, improved the survival rate, and shortened the hospital stay.
CONCLUSION
Early surgical exploration within 12 h may be more effective for the treatment of IAIs relative to a delayed operation.
Core Tip: The available evidence regarding the optimal timing of intra-abdominal infection surgery is still limited. In a systematic review and meta-analysis of the cohort study, we compared the effects of operation time on patients with abdominal cavity infection and aimed to confirm the best timing of surgery.
