Is it safe to leave rectal wound opened after transanal microsurgery? A systematic review and meta-analysis.
https://doi.org/10.33878/2073-7556-2024-23-1-181-187
Abstract
INTRODUCTION: there is no consensus on the need for closure of rectal wounds after transanal endomicrosurgery (TEM). The results of studies on the treatment of patients using open and closed wound management are presented in this meta-analysis.
AIM: to compare 2 methods of rectal wound management in patients after TEM.
MATERIALS AND METHODS: a systematic review and meta-analysis was performed in accordance with PRISMA guidelines.
RESULTS: six studies were selected for the period from 2002 to 2021. The meta-analysis included 808 patients: in 383 (47%) patients the rectal wound was managed openly, in 425 (53%) patients it was sutured. The incidence of postoperative bleeding was 6% (23/383) in the open wound management group vs. 3.3% (14/425) (OR 0.47; 95%CI 0.18–1.26). The infection rate was 3.3% (14/425) in the suturing group vs. 1.8% (7/383) in the open wound management group (OR 1.66; 95%CI 0.69 — 4.00). Mean operating time in the group with suturing of the rectal wound is 7–8 minutes longer; 95%CI -2.21-17.6. Mean postoperative hospital stay for patients in the rectal wound suturing group was increased by 12 hours.
CONCLUSION: wound suturing after TEM does not lead to significant reduction of postoperative bleeding and infection.
About the Authors
R. K. Sinitsyn
Ryzhikh National Medical Research Center of Coloproctology
Salyama Adilya str., 2, Moscow, 123423
Russian Medical Academy of Continuous Professional Education
Barrikadnaya str., 2/1-1, Moscow, 125993
Russian Federation
Russian Federation
Salyama Adilya str., 2, Moscow, 123423
M. V. Alekseev
Ryzhikh National Medical Research Center of Coloproctology; Russian Medical Academy of Continuous Professional Education
Russian Federation
Russian Federation
Salyama Adilya str., 2, Moscow, 123423
Barrikadnaya str., 2/1-1, Moscow, 125993
S. V. Chernyshov
Ryzhikh National Medical Research Center of Coloproctology
Russian Federation
Russian Federation
Salyama Adilya str., 2, Moscow, 123423
E. G. Rybakov
Ryzhikh National Medical Research Center of Coloproctology
Russian Federation
Russian Federation
Salyama Adilya str., 2, Moscow, 123423
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Review
For citations:
Sinitsyn R.K., Alekseev M.V., Chernyshov S.V., Rybakov E.G. Is it safe to leave rectal wound opened after transanal microsurgery? A systematic review and meta-analysis. Koloproktologia. 2024;23(1):181-187. https://doi.org/10.33878/2073-7556-2024-23-1-181-187
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