Systematic review of level 1 evidence for laparoscopic pediatric surgery: do our procedures comply with the requirements of evidence-based medicine?

摘要: Introduction Laparoscopic techniques have evolved quickly in recent years and are regarded as standard procedures pediatric surgery today. However, most studies comparing laparoscopic operations with the corresponding open procedure do not reach a high level of evidence according to criteria Oxford Centre for Evidence-Based Medicine. For Level 1a, meta-analysis (MA) different randomized controlled trials (RCTs) is required. 1b, at least one RCT The aim our study was evaluate availability 1 operation surgery. Materials Methods Systematic review clinical using PubMed. All MA were identified individually reviewed. Only included. RCTs included only analyzed if they focused on additional endpoints. Endpoints advantages disadvantages laparoscopy compared operation. Results A total 20 manuscripts met inclusion (9 11 RCT). Studies providing 1a five types (laparoscopic appendectomy, inguinal hernia repair, orchidopexy, pyloromyotomy, varicocelectomy). 1b two (fundoplication pyeloplasty). less wound infections, ileus postoperative pain (appendectomy), retching (fundoplication), lower incidence metachronous hernia, shorter hospital stay (appendectomy, orchiopexy, pyeloplasty), time full feeds (pyloromyotomy). Conclusion Studies available seven Effort has be made extend existing gain further procedures.