Scolaris Content Display Scolaris Content Display

Study flow diagram.
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Figure 1

Study flow diagram.

Risk of bias graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.
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Figure 2

Risk of bias graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.

Risk of bias summary: review authors' judgements about each risk of bias item for each included study.
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Figure 3

Risk of bias summary: review authors' judgements about each risk of bias item for each included study.

Comparison 1 Hand‐assisted laparoscopic repair vs EVAR, Outcome 1 In‐hospital mortality.
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Analysis 1.1

Comparison 1 Hand‐assisted laparoscopic repair vs EVAR, Outcome 1 In‐hospital mortality.

Comparison 1 Hand‐assisted laparoscopic repair vs EVAR, Outcome 2 Operative time (minutes).
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Analysis 1.2

Comparison 1 Hand‐assisted laparoscopic repair vs EVAR, Outcome 2 Operative time (minutes).

Comparison 1 Hand‐assisted laparoscopic repair vs EVAR, Outcome 3 Major complications.
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Analysis 1.3

Comparison 1 Hand‐assisted laparoscopic repair vs EVAR, Outcome 3 Major complications.

Summary of findings for the main comparison. Hand‐assisted laparoscopic repair compared to EVAR for elective abdominal aortic aneurysm repair

Hand‐assisted laparoscopic repair compared to EVAR for elective abdominal aortic aneurysm repair

Patient or population: People undergoing elective abdominal aortic aneurysm repair
Setting: Hospital
Intervention: Hand‐assisted laparoscopic AAA repair
Comparison: EVAR

Outcomes

Anticipated absolute effects* (95% CI)

Relative effect
(95% CI)

№ of participants
(studies)

Quality of the evidence
(GRADE)

Comments

Risk with EVAR

Risk with hand‐assisted laparoscopic repair

In‐hospital mortality

see comment

Not estimable

100
(1 RCT)

⊕⊕⊝⊝
LOW 1 2

0 participants died while in hospital in this study

Operative time (minutes)

The mean operative time was 125 minutes

The mean operative time was 53 minutes longer
(36.49 longer to 69.51 longer)

100
(1 RCT)

⊕⊕⊝⊝
LOW 1 2

Major complications ‐ lower limb ischaemia (up to 12 months)

Study population

RR 0.50
(0.05 to 5.34)

100
(1 RCT)

⊕⊕⊝⊝
LOW 1 2

40 per 1000

20 per 1000
(2 to 214)

Long‐term complications (12 months or longer if reported)

see comment

outcome not reported

All‐cause mortality/survival (> 30 days)

see comment

outcome not reported

Length of ICU stay (days)

see comment

outcome not reported

Overall length of hospital stay (days)

The mean length of hospital stay was 3.4 days

The mean length of hospital stay was 4.2 days

Not estimable

100
(1 RCT)

⊕⊕⊝⊝
LOW 1 2

Standard deviations around the mean length of hospital stay were not reported

*The risk in the intervention group (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI).

CI: confidence interval; EVAR: endovascular repair; ICU: intensive care unit; RR: risk ratio

GRADE Working Group grades of evidence
High quality: we are very confident that the true effect lies close to that of the estimate of the effect
Moderate quality: we are moderately confident in the effect estimate: the true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different
Low quality: our confidence in the effect estimate is limited: the true effect may be substantially different from the estimate of the effect
Very low quality: we have very little confidence in the effect estimate: the true effect is likely to be substantially different from the estimate of effect

1 Risk of bias was unclear for detection bias in the included studies but we did not consider it sufficient enough to downgrade the quality of the evidence
2 Quality of evidence was downgraded for imprecision due to the inclusion of one small study and wide confidence intervals and indirectness due to the study including male participants only

Figuras y tablas -
Summary of findings for the main comparison. Hand‐assisted laparoscopic repair compared to EVAR for elective abdominal aortic aneurysm repair
Comparison 1. Hand‐assisted laparoscopic repair vs EVAR

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 In‐hospital mortality Show forest plot

1

100

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

2 Operative time (minutes) Show forest plot

1

100

Mean Difference (IV, Fixed, 95% CI)

53.0 [36.49, 69.51]

3 Major complications Show forest plot

1

100

Risk Ratio (M‐H, Fixed, 95% CI)

0.5 [0.05, 5.34]

3.1 Lower limb ischaemia

1

100

Risk Ratio (M‐H, Fixed, 95% CI)

0.5 [0.05, 5.34]

Figuras y tablas -
Comparison 1. Hand‐assisted laparoscopic repair vs EVAR