Laparoscopic versus open loop ileostomy reversal: A systematic review and meta-analysis
Bibliographic record
Abstract
Loop ileostomies (LIs) are used for temporary fecal diversion to protect downstream colorectal anastomoses. Standard operative approach for LI reversal has been through an open technique. Recently, laparoscopic LI reversal has been employed and studied. The aim of this systematic review was to compare laparoscopic and open LI reversal. Medline, Embase, and CENTRAL were systematically searched. Articles were included if they compared rate of postoperative morbidity and/or length of stay (LOS) in patients undergoing laparoscopic or open LI reversal. Pairwise meta-analyses using inverse variance random effects was performed. The Grading of Recommendations, Assessment, Development, and Evidence (GRADE) approach was conducted to assess quality of evidence. From 410 citations, four observational studies with 213 patients undergoing laparoscopic LI reversal and 176 patients undergoing open LI reversal met inclusion. Patients in the laparoscopic group had significantly shorter LOS (MD -0.39, 95%CI -0.73 to -0.04, p = 0.03). Laparoscopic and open LI reversal were comparable in postoperative morbidity, aside from a decrease of superficial surgical site infection (sSSI) with the use of laparoscopy (OR 0.22, 95%CI 0.07 to 0.71, p = 0.01). Operative time was not significantly different between groups (MD 11.91, 95%CI -1.87 to 25.70, p = 0.09). The GRADE quality of evidence was low to very low. This review presents low quality evidence that laparoscopic LI reversal is a feasible approach that may reduce postoperative LOS and sSSI compared to open LI reversal without increasing operative time. Future prospective comparative studies are required to confirm the findings of the present review.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.007 | 0.011 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.009 | 0.001 |
| Bibliometrics | 0.001 | 0.007 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".