Title: Advantages Comparison of Peritoneal Drainage versus No Drainage after Laparoscopic
Appendectomy for Complicated Appendicitis: A Meta-analysis
Version: 4 Date: 20 Oct 2024
Reviewer's report:
Dear authors,
You have carefully completed and revised your manuscript in accordance with the instructions
of all reviewers. The quality of your meta-analysis has been further improved by focusing on
complicated appendicitis. This is a study on a highly relevant topic. Unfortunately, retrospetitive
studies have been carried out on this issue for the most part. You have addressed the issue very
well with the methodology you have used, so that in the end a general recommendation can be
made to not use a drain in complicated appendicitis.
One more personal comment (own opinion): In a) cholecystectomy and b) pancreatic resections,
drains are predominantly inserted for a different purpose, namely a) early detection of a bile
leak or b) a pancreatic fistula. If the drainage secretion is unremarkable (no bile, no elevated
pancreatic enzymes), the drain can be removed at an early stage. If there are elevated pancreatic
enzymes or bile in the drainage secretion, the drainage can drain this off, which means that
conservative treatment is possible in most cases. Therefore, the indications for drainage in
appendectomy, cholecystectomy and pancreatic resection are hardly comparable.
I had already recommended acceptance for publication in my first evaluation. I stand by this:
accept.
Title: Advantages Comparison of Peritoneal Drainage versus No Drainage after Laparoscopic
Appendectomy for Complicated Appendicitis: A Meta-analysis
Version: 4 Date: 20 Oct 2024
Reviewer's report:
Dear authors,
You have carefully completed and revised your manuscript in accordance with the instructions
of all reviewers. The quality of your meta-analysis has been further improved by focusing on
complicated appendicitis. This is a study on a highly relevant topic. Unfortunately, retrospetitive
studies have been carried out on this issue for the most part. You have addressed the issue very
well with the methodology you have used, so that in the end a general recommendation can be
made to not use a drain in complicated appendicitis.
One more personal comment (own opinion): In a) cholecystectomy and b) pancreatic resections,
drains are predominantly inserted for a different purpose, namely a) early detection of a bile
leak or b) a pancreatic fistula. If the drainage secretion is unremarkable (no bile, no elevated
pancreatic enzymes), the drain can be removed at an early stage. If there are elevated pancreatic
enzymes or bile in the drainage secretion, the drainage can drain this off, which means that
conservative treatment is possible in most cases. Therefore, the indications for drainage in
appendectomy, cholecystectomy and pancreatic resection are hardly comparable.
I had already recommended acceptance for publication in my first evaluation. I stand by this:
accept.
Please review this paper.
user
Title: Advantages Comparison of Peritoneal Drainage versus No Drainage after Laparoscopic
Appendectomy for Complicated Appendicitis: A Meta-analysis
Version: 4 Date: 20 Oct 2024
Reviewer's report:
Dear authors,
You have carefully completed and revised your manuscript in accordance with the instructions
of all reviewers. The quality of your meta-analysis has been further improved by focusing on
complicated appendicitis. This is a study on a highly relevant topic. Unfortunately, retrospetitive
studies have been carried out on this issue for the most part. You have addressed the issue very
well with the methodology you have used, so that in the end a general recommendation can be
made to not use a drain in complicated appendicitis.
One more personal comment (own opinion): In a) cholecystectomy and b) pancreatic resections,
drains are predominantly inserted for a different purpose, namely a) early detection of a bile
leak or b) a pancreatic fistula. If the drainage secretion is unremarkable (no bile, no elevated
pancreatic enzymes), the drain can be removed at an early stage. If there are elevated pancreatic
enzymes or bile in the drainage secretion, the drainage can drain this off, which means that
conservative treatment is possible in most cases. Therefore, the indications for drainage in
appendectomy, cholecystectomy and pancreatic resection are hardly comparable.
I had already recommended acceptance for publication in my first evaluation. I stand by this:
accept.
assistant