Reviewer's report
Title:Laparoscopic versus conventional appendectomy - a meta-analysis of
randomized controlled trials
Version: 1Date:30 August 2010
Reviewer: Anette Sundfor Jacobsen
Reviewer's report:
In the Abstract, authors set out to compare therapeutic effects and safety.......via
a meta-analysis. This purpose must follow through in the discussion and
conclusion.
Effect size as included in the methods / abstract should be immediately
described and explained. the conclusion in the abstract does not refer to
Therapeutic effect and or safety.
In Background - I do not agree that Lap Appendectomy has not gained
widespread acceptance. In the majority of surgical units - this is what we do.
Background last sentence - suggest saying ....LA or OA gives better patient
outcome rather than saying - is superior.
Method - OK.
You have included SAGES and EAES, what about IPEG?? (International
Pediatric Endosurgery Group)
I think hospital cost shopuld be left out if all the studies included cannot be
compared. When the paper deals with several articles from countries where the
funding models are so disparate, this does not serve as any useful parameter.
While we study immediate or early postoperative complications, it is much more
interesting I think to look at incidences of late adhesive obstructions. It could be
postulated that a minimally invasive approach will in the long term lead to lower
incedences of adhesions and or adhesive obstructions. This would be a true
benefit of a minimally invasive approach.
Methodological quality assessment: second sentence can be excluded, as this is
in the table.
Operating time - many studies focus on operating time, and with a Minimally
Invasive approach - we all get better with time - I question the continued focus on
operating time, I do not see this as so important.
When we study Postoperative pain, The way this is studied, it will only tell us if
Pain was well managed in the hospital (studies) rerally it should be analgesia use
that was studied to see if there was any clinical difference.
Thirty studies reported post-op wound infection rates.
What proportion of cases were perforated or simple, and how does this relate to
the cases studied. When we do a meta-analysis of appendectomy studies - we
also know that all these cases are not the same, and studies will all have
selection bias.
relating to UTI - do the articles studied comment on patient cathetrisation and
relation to UTI??
The discussion has numerous grammatical and syntax errors.
I think Figure 1 - 12 should be combined and summarised as results only into
perhaps two tables.
Having 12 figures or tables is meaningless, and may be of interest to
statisticians, but not to a surgical or GE readership.
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Needs some language corrections before being
published
Statistical review: Yes, and I have assessed the statistics in my report.
Declaration of competing interests:
i declare that I have no competing interests
Reviewer's report
Title:Laparoscopic versus conventional appendectomy - a meta-analysis of
randomized controlled trials
Version: 1Date:30 August 2010
Reviewer: Anette Sundfor Jacobsen
Reviewer's report:
In the Abstract, authors set out to compare therapeutic effects and safety.......via
a meta-analysis. This purpose must follow through in the discussion and
conclusion.
Effect size as included in the methods / abstract should be immediately
described and explained. the conclusion in the abstract does not refer to
Therapeutic effect and or safety.
In Background - I do not agree that Lap Appendectomy has not gained
widespread acceptance. In the majority of surgical units - this is what we do.
Background last sentence - suggest saying ....LA or OA gives better patient
outcome rather than saying - is superior.
Method - OK.
You have included SAGES and EAES, what about IPEG?? (International
Pediatric Endosurgery Group)
I think hospital cost shopuld be left out if all the studies included cannot be
compared. When the paper deals with several articles from countries where the
funding models are so disparate, this does not serve as any useful parameter.
While we study immediate or early postoperative complications, it is much more
interesting I think to look at incidences of late adhesive obstructions. It could be
postulated that a minimally invasive approach will in the long term lead to lower
incedences of adhesions and or adhesive obstructions. This would be a true
benefit of a minimally invasive approach.
Methodological quality assessment: second sentence can be excluded, as this is
in the table.
Operating time - many studies focus on operating time, and with a Minimally
Invasive approach - we all get better with time - I question the continued focus on
operating time, I do not see this as so important.
When we study Postoperative pain, The way this is studied, it will only tell us if
Pain was well managed in the hospital (studies) rerally it should be analgesia use
that was studied to see if there was any clinical difference.
Thirty studies reported post-op wound infection rates.
What proportion of cases were perforated or simple, and how does this relate to
the cases studied. When we do a meta-analysis of appendectomy studies - we
also know that all these cases are not the same, and studies will all have
selection bias.
relating to UTI - do the articles studied comment on patient cathetrisation and
relation to UTI??
The discussion has numerous grammatical and syntax errors.
I think Figure 1 - 12 should be combined and summarised as results only into
perhaps two tables.
Having 12 figures or tables is meaningless, and may be of interest to
statisticians, but not to a surgical or GE readership.
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Needs some language corrections before being
published
Statistical review: Yes, and I have assessed the statistics in my report.
Declaration of competing interests:
i declare that I have no competing interests
Please review this paper.
user
Reviewer's report
Title:Laparoscopic versus conventional appendectomy - a meta-analysis of
randomized controlled trials
Version: 1Date:30 August 2010
Reviewer: Anette Sundfor Jacobsen
Reviewer's report:
In the Abstract, authors set out to compare therapeutic effects and safety.......via
a meta-analysis. This purpose must follow through in the discussion and
conclusion.
Effect size as included in the methods / abstract should be immediately
described and explained. the conclusion in the abstract does not refer to
Therapeutic effect and or safety.
In Background - I do not agree that Lap Appendectomy has not gained
widespread acceptance. In the majority of surgical units - this is what we do.
Background last sentence - suggest saying ....LA or OA gives better patient
outcome rather than saying - is superior.
Method - OK.
You have included SAGES and EAES, what about IPEG?? (International
Pediatric Endosurgery Group)
I think hospital cost shopuld be left out if all the studies included cannot be
compared. When the paper deals with several articles from countries where the
funding models are so disparate, this does not serve as any useful parameter.
While we study immediate or early postoperative complications, it is much more
interesting I think to look at incidences of late adhesive obstructions. It could be
postulated that a minimally invasive approach will in the long term lead to lower
incedences of adhesions and or adhesive obstructions. This would be a true
benefit of a minimally invasive approach.
Methodological quality assessment: second sentence can be excluded, as this is
in the table.
Operating time - many studies focus on operating time, and with a Minimally
Invasive approach - we all get better with time - I question the continued focus on
operating time, I do not see this as so important.
When we study Postoperative pain, The way this is studied, it will only tell us if
Pain was well managed in the hospital (studies) rerally it should be analgesia use
that was studied to see if there was any clinical difference.
Thirty studies reported post-op wound infection rates.
What proportion of cases were perforated or simple, and how does this relate to
the cases studied. When we do a meta-analysis of appendectomy studies - we
also know that all these cases are not the same, and studies will all have
selection bias.
relating to UTI - do the articles studied comment on patient cathetrisation and
relation to UTI??
The discussion has numerous grammatical and syntax errors.
I think Figure 1 - 12 should be combined and summarised as results only into
perhaps two tables.
Having 12 figures or tables is meaningless, and may be of interest to
statisticians, but not to a surgical or GE readership.
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Needs some language corrections before being
published
Statistical review: Yes, and I have assessed the statistics in my report.
Declaration of competing interests:
i declare that I have no competing interests
assistant