A randomised controlled study of non-closure of peritoneum at caesarean section in a Nigerian population

Oo, Malomo; O, Kuti; Eo, Orji; So, Ogunniyi; Sule, S S

doi:10.1080/01443610600720287

Cited by 18 publications

(5 citation statements)

References 7 publications

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“…Surgical peritoneal closure resulted in more advanced adhesion formation. The practice of peritoneum nonclosure should be observed at cesarean delivery [34].…”

Section: Discussionmentioning

confidence: 99%

Minimizing bladder injury in laparoscopically assisted vaginal hysterectomy among women with previous cesarean sections

et al. 2007

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“…Surgical peritoneal closure resulted in more advanced adhesion formation. The practice of peritoneum nonclosure should be observed at cesarean delivery [34].…”

Section: Discussionmentioning

confidence: 99%

Minimizing bladder injury in laparoscopically assisted vaginal hysterectomy among women with previous cesarean sections

et al. 2007

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“…Three trials involving 889 women showed no reduction in postoperative fever (average RR 0.60, 95% CI 0.29 to 1.27; Heterogeneity: Tau² = 0.28; Chi² = 6.26, df = 2; P = 0.04); I² = 68%), Analysis 2.3 , and two showed a reduction in wound infection (RR 0.36, 95% CI 0.14 to 0.89), Analysis 2.2 . There was no difference in the one trial (Weerawetwat 2004 ), that assessed for endometritis, (RR 3.00, 95% CI 0.12 to 72.91), Analysis 2.4 .…”

Section: Methodsmentioning

confidence: 99%

“…In two trials involving 157 women, adhesions formation was increased in the visceral peritoneal non-closure group (Malvasi 2009 ; Weerawetwat 2004 ) (RR 2.49 and 95% CI 1.49 to 4.16), Analysis 2.1 . This effect was seen only in one of the trials (Malvasi 2009 ), which was at high risk of bias.…”

Section: Methodsmentioning

confidence: 99%

Closure versus non-closure of the peritoneum at caesarean section: short- and long-term outcomes

Bamigboye

Hofmeyr

2014

Cochrane Database of Systematic Reviews

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Background Caesarean section is a very common surgical procedure worldwide. Suturing the peritoneal layers at caesarean section may or may not confer benefit, hence the need to evaluate whether this step should be omitted or routinely performed. Objectives The objective of this review was to assess the effects of non-closure as an alternative to closure of the peritoneum at caesarean section on intraoperative and immediate- and long-term postoperative outcomes. Search methods We searched the Cochrane Pregnancy and Childbirth Group’s Trials Register (1 November 2013). Selection criteria Randomised controlled trials comparing leaving the visceral or parietal peritoneum, or both, unsutured at caesarean section with a technique which involves suturing the peritoneum in women undergoing elective or emergency caesarean section. Data collection and analysis Two review authors independently assessed trials for inclusion and risk of bias, extracted data and checked it for accuracy. Main results A total of 29 trials were included in this review and 21 trials (17,276 women) provided data that could be included in an analysis. The quality of the trials was variable. 1. Non-closure of visceral and parietal peritoneum versus closure of both parietal layers Sixteen trials involving 15,480 women, were included and analysed, when both parietal peritoneum was left unclosed versus when both peritoneal surfaces were closed. Postoperative adhesion formation was assessed in only four trials with 282 women, and no difference was found between groups (risk ratio (RR) 0.99, 95% confidence interval (CI) 0.76 to 1.29). There was significant reduction in the operative time (mean difference (MD) -5.81 minutes, 95% CI -7.68 to -3.93). The duration of hospital stay in a total of 13 trials involving 14,906 women, was also reduced (MD -0.26, 95% CI -0.47 to -0.05) days. In a trial involving 112 women, reduced chronic pelvic pain was found in the peritoneal non-closure group. 2. Non-closure of visceral peritoneum only versus closure of both peritoneal surfaces Three trials involving 889 women were analysed. There was an increase in adhesion formation (two trials involving 157 women, RR 2.49, 95% CI 1.49 to 4.16) which was limited to one trial with high risk of bias.There was reduction in operative time, postoperative days in hospital and wound infection. There was no significant reduction in postoperative pyrexia. 3. Non-closure of parietal peritoneum only versus closure of both peritoneal layers The two identified trials involved 573 women. Neither study reported on postoperative adhesion formation. There was reduction in operative time and postoperative pain with no difference in the incidence of postoperative pyrexia, endometritis, postoperative duration of hospital stay and wound infection. In only one...

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“…Otros estudios no encontraron diferencias en el número de dosis de analgesia parenteral, pero si encontraron una menor cantidad de necesidad de analgesia de rescate en el grupo que no se realizó el cierre y disminución significativa en la necesidad de analgesia con opiáceos 16,22 . Malomo et al 23 reportaron menor uso de analgesia narcótica en las pacientes en las cuales no se realizaba la peritonización. Una investigación previa no encontró diferencias entre los grupos con respecto al dolor postoperatorio, pero la movilización e ingesta oral fueron significativamente más temprana en el grupo sin cierre peritoneal 24 .…”

Section: Discussionunclassified

“…Varios estudios no han demostrado diferencias en la frecuencia de fiebre post-operatoria, endometritis o infección de la herida quirúrgica 15,16,20 . Contrario a lo previamente expuesto, otras dos investigaciones encontraron disminución significativa en la frecuencia de morbilidad febril en las pacientes que no se realizó la peritonización, sin diferencias en la incidencia de endometritis o infección del tracto urinario 23,26 . El meta-analisis previamente citado, demostró que la morbilidad febril, endometritis e infección de la herida fue menor en el grupo en el que no se realizó el cierre, aunque esta diferencia no fue significativa 1 .…”

Section: Discussionunclassified

Resultante Materna a Corto Plazo Del Cierre O No Del Peritoneo Durante La Cesárea.

Mejia-Montilla

Reyna-Villasmil

Torres-Cepeda

et al. 2019

Rev. chil. obstet. ginecol.

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RESUMENOBJETIVO: Comparar la resultante materna a corto plazo del cierre o no del peritoneo durante la cesárea. MÉTODOS: Se realizó un estudio al azar, doble ciego y controlado en embarazadas que asistieron al Hospital Central "Dr. Urquinaona", Maracaibo, Venezuela. Las pacientes seleccionadas se asignaron al azar al grupo A (grupo no intervenido, cirugía sin cierre peritoneal) y Grupo B (grupo intervenido, cirugía con cierre peritoneal). Se evaluaron características generales, duración de la cirugía, concentraciones de hemoglobina posterior a la cirugía, duración de la hospitalización, dolor post-operatorio, necesidad de analgesia de rescate y frecuencia de complicaciones post-operatorias. RESULTADOS: Se seleccionaron para el análisis final 247 pacientes en el grupo A y 248 pacientes en el grupo B. Se observó que las pacientes del grupo A presentaban duración de la cirugía significativamente menor comparado con las pacientes del grupo B (p < 0,0001). No se observaron diferencias en valores de hemoglobina post-operatoria, tiempo de hospitalización, intensidad de dolor postoperatorio, aparición de ruidos hidroaéreos y complicaciones post-operatorias (p = ns). CONCLUSIÓN: No realizar la peritonización no parece tener efectos negativos sobre la resultante materna a corto plazo en comparación con los casos en las que si se realiza.ABSTRACT OBJECTIVE: To compare short-term maternal outcome of the closure or not of peritoneum during cesarean section. METHODS: A randomized, double-blind and controlled study was conducted on pregnant women who attended at Hospital Central "Dr. Urquinaona", Maracaibo, Venezuela. The selected patients were randomly assigned to group A (non-intervened group, surgery without peritoneal closure) and group B (intervened group, surgery with peritoneal closure). General characteristics, duration of surgery, hemoglobin concentrations after surgery, duration of hospitalization, post-operative pain, need for rescue analgesia and frequency of postoperative complications was evaluated. RESULTS: A total of 247 patients in group A and 248 patients in group B were selected for the final analysis. It was observed that patients in group A had a significantly shorter duration of surgery compared to patients in group B (p <0.0001). No differences were observed in postoperative hemoglobin values, hospitalization time, postoperative pain intensity, return of bowel movements and postoperative complications (p = ns). CONCLUSION: To not perform peritonization does not appear to have negative effects on the short-term maternal outcome compared with cases which it is done.

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A randomised controlled study of non-closure of peritoneum at caesarean section in a Nigerian population

Cited by 18 publications

References 7 publications

Minimizing bladder injury in laparoscopically assisted vaginal hysterectomy among women with previous cesarean sections

Minimizing bladder injury in laparoscopically assisted vaginal hysterectomy among women with previous cesarean sections

Closure versus non-closure of the peritoneum at caesarean section: short- and long-term outcomes

Resultante Materna a Corto Plazo Del Cierre O No Del Peritoneo Durante La Cesárea.

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