Meta-Analysis
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
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 by Taishan 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
Processing time: 239 Days and 8.6 Hours
ARTICLE HIGHLIGHTS
Research 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.

Research motivation

We compared the effects of operation time on patients with abdominal cavity infection and tried to confirm the best timing of surgery.

Research objectives

This study aimed to assess the efficacy of early vs delayed surgical exploration in the treatment of IAI, in terms of overall mortality.

Research 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.

Research 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.

Research conclusions

Early surgical exploration within 12 h may be more effective for the treatment of IAIs relative to a delayed operation.

Research perspectives

In this study, we developed a strict and reasonable study design, literature search strategy and screening and quality evaluation, selected appropriate statistical analysis methods, and analyzed the results’ scientificity and sensitivity.