Effect of minimally invasive surgery and laparotomy on wound infection and postoperative and intraoperative complications in the management of cervical cancer: A meta-analysis

A meta-analysis of postoperative wound complications at the surgical site in prostate cancer patients undergoing robotic surgery

This meta-analysis critically evaluates the role of robotic surgery in reducing postoperative wound complications in prostate cancer patients, comparing it with traditional open and laparoscopic approaches. Our extensive literature search resulted in 9 studies comprising 2063 patients. The results highlighted a significant reduction in the incidence of wound complications, with an 84% heterogeneity index and a standardized mean difference (SMD) of 0.49 (95% Confidence Intervals: 0.42 to 0.58, p < 0.01) in favour of robotic surgery. Additionally, a notable decrease in wound infection rates was observed, marked by a 94% heterogeneity index and a SMD of 0.26 (95% CIs: 0.19 to 0.35, p < 0.01). A considerable reduction in wound dehiscence events was also noted, particularly in a subset of studies, reflecting a 70% heterogeneity index and a SMD of 0.23 (95% CIs: 0.12 to 0.45, p < 0.01). These findings suggest that robotic surgery may offer significant advantages in managing wound-related outcomes in prostate cancer surgeries. However, the variability among the studies warrants cautious interpretation of the results and underscores the need for more targeted research in this area.

A Narrative Review on Intraoperative Adverse Events: Risks, Prevention, and Mitigation

INTRODUCTION

Adverse events from surgical interventions are common. They can occur at various stages of surgical care, and they carry a heavy burden on the different parties involved. While extensive research and efforts have been made to better understand the etiologies of postoperative complications, more research on intraoperative adverse events (iAEs) remains to be done.

METHODS

In this article, we reviewed the literature looking at iAEs to discuss their risk factors, their implications on surgical care, and the current efforts to mitigate and manage them.

RESULTS

Risk factors for iAEs are diverse and are dictated by patient-related risk factors, the nature and complexity of the procedures, the surgeon's experience, and the work environment of the operating room. The implications of iAEs vary according to their severity and include increased rates of 30-day postoperative morbidity and mortality, increased length of hospital stay and readmission, increased care cost, and a second victim emotional toll on the operating surgeon.

CONCLUSIONS

While transparent reporting of iAEs remains a challenge, many efforts are using new measures not only to report iAEs but also to provide better surveillance, prevention, and mitigation strategies to reduce their overall adverse impact.