Diathermy Versus Scalpel in Midline Abdominal Incision: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Nicole Dos Santos Pimenta, Ana Clara Felix de Farias Santos, João Pedro Costa Esteves Almuinha Salles, Juliana Millani de Oliveira, Pedro Henrique Costa Matos da Silva, Renan Carlo Colombari
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Abstract

Introduction: Our study aimed to compare the midline abdominal incision with scalpel and diathermy.

Methods: PubMed, EMBASE, and Cochrane were searched through January 2024 following PRISMA guidelines (PROSPERO, ID: CRD42024516771), and only randomized controlled trials were included. Heterogeneity was assessed using Cochran's Q test and the I2 heterogeneity index. Statistical analysis was performed using Review Manager 5.4 software.

Results: Six randomized controlled trials were included, from which 469 patients (51.5%) received diathermy incision and 442 patients (48.5%) underwent the scalpel technique. Patients treated with the electrocautery approach had less incision blood loss (MD -17.57 mL; P < .01). No statistically significant differences were found between groups regarding wound infection incidence, incision time, incision area or first-day postoperative pain.

Conclusion: Diathermy use in midline abdominal incision may be advocated as it demonstrated a significant reduction in incision-related blood loss, with no differences in wound infection or early postoperative pain incidences compared to the scalpel.

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腹部中线切开术中的热疗与手术刀:随机对照试验的系统回顾和元分析》。
简介我们的研究旨在比较腹部中线切口与手术刀和电热疗法:按照 PRISMA 指南(PROSPERO,ID:CRD42024516771)检索了 PubMed、EMBASE 和 Cochrane,检索期至 2024 年 1 月,仅纳入了随机对照试验。异质性采用 Cochran's Q 检验和 I2 异质性指数进行评估。使用Review Manager 5.4软件进行统计分析:共纳入了 6 项随机对照试验,其中 469 名患者(51.5%)接受了电热切口术,442 名患者(48.5%)接受了手术刀技术。采用电灼法治疗的患者切口失血量较少(MD -17.57 mL; P 结论:电灼法在中线腹腔镜手术中的应用可减少切口失血量:腹部中线切开术中使用电热疗法可显著减少切口相关失血量,与手术刀相比,伤口感染或术后早期疼痛发生率没有差异,因此值得提倡。
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