A randomized study comparing non-closure and closure of visceral and parietal peritoneum during cesarean section

Ghongdemath, Jyoti S.; Banale, S. B.

doi:10.1007/s13224-011-0016-9

Cited by 6 publications

(7 citation statements)

References 9 publications

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“…In several studies the method of random allocation was not specified. A quasi-random method of allocation was used in the trials of Hull 1991 , Komoto 2005 , Moraes 1999 , Nagele 1996 , and Pietrantoni 1991 .…”

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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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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“…The mean gestational age was 38.67 ± 1.05 weeks in closure group and 38.83±0.86 weeks in non-closure group, in the study by Ghongdemath and Banale (7) it was 37.5 ± 2.3 weeks in closure group and 37.6 ± 2.0 weeks in non-closure group.…”

Section: Discussionmentioning

confidence: 78%

“…In this study there was significant statistical difference regarding operative time, as the operative time was shorter (8.9 minutes) in the non-closure group than the closure group. Rafique et al (6) revealed a reduction in operative time (6 minutes) in the nonclosure group than in the closure group, Bamigboye and Hofmeyer (8) revealed a reduction in operative time (7.33 minutes) in women who had both peritoneal surfaces unsutured in comparison with sutured peritoneum, Ghongdemath and Banale (7) revealed a reduction in operative time (11.2 minutes) in the nonclosure group than the closure group and in the study by Tabasi et al (9) the operative time was shorter (6.89 minutes) in the non-closure group than in the closure group. The decrease in operative time reduced the duration of anesthesia time exposure and that of exposure of wound to the environmental contaminants.…”

Section: Discussionmentioning

confidence: 96%

Short Term Outcome of Closure or Non-Closure of Peritoneum in Caesarian Section

Ali¹,

Ibrahim²,

Abdel-Aziz³

et al. 2021

The Egyptian Journal of Hospital Medicine

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Background: Cesarean section (CS) can be considered as one of the most frequently performed surgical procedure worldwide, accounting for up to 70% of deliveries, depending on the facility being assessed and the country involved. In Egypt its rate reach about 51.8% from deliveries. Objetive: To compare closure versus non-closure of visceral and parietal peritoneum during primary cesarean section regarding early postoperative outcome. Patients and Methods: A randomized-controlled study that was conducted at Ismailia General Hospitals during the period from November 2018 to March 2019. Included 142 pregnant women attending Obstetrics and Gynecology Department for primary cesarean section who were divided into two groups. Group I (Control) 71 patients with closure of both the visceral and parietal peritoneum (Study) 71 patients with non-closure of both the visceral and parietal peritoneum. Patients were assessed for intra-operative parameters including operation time. Postoperatively, patients were assessed for pain degree, distention, fever, regain of intestinal sound, wound infection and duration of hospital stay. Results: There was statistically significant difference between both groups regarding age, BMI, parity, gestational age and type of CS. Non-closure technique of both visceral and parietal peritoneum in CS is associated with shorter operation time, less postoperative pain score, rapid regain of intestinal motility and less duration of hospital stay. Conclusion: Non-closure of both visceral and parietal peritoneum at CS is associated with less operative time, less postoperative pain and distention and wound infection hence routine closure of peritoneum at CS can be avoided.

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“…Febrile morbidity was defined as a nonspecific fever above 38 degree Celsius on two occasions at least twelve hours apart. 13 Tenderness of the uterus and offensive lochia with fever was diagnosed as Endomyometritis. Wound infection was diagnosed by erythema, induration, or purulent discharge from the skin.…”

Section: Methodsmentioning

confidence: 99%

“…3) Non-closure of the peritoneum reduces the amount of surgical intervention and saves on valuable operating time and cost. 1,2,3,6,13,14,15,16 The objective of this study was to assess the effects of nonclosure and closure of the peritoneum at caesarean section.…”

Section: Introductionmentioning

confidence: 99%

Advantage of Non-Closure of the Peritoneum at Caesarean Section

Bhaumik¹

2016

jemds

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OBJECTIVETo determine advantage of non-closure of peritoneum at LSCS over of closure of peritoneum with regard to postoperative complications. STUDY DESIGNProspective randomized controlled trial. SETTINGTripura Medical College and Dr. BRAM Teaching Hospital, Hapania, Tripura. SUBJECTS AND METHODSThree hundreds term pregnant women undergoing first cesarean section were divided into 2 groups (N = 150). Group I: Non-closure of both visceral and parietal peritoneum. Group II: closure of both visceral and parietal peritoneum. Postoperative complications were compared. Adhesions were evaluated in 50 patients in each group returning for a second LSCS and compared for severity of adhesions. RESULTThere was statistical difference between group I and II for postoperative complications or number of adhesion formation. However, adhesions in the closure group were more severe. CONCLUSIONSNon closure of visceral and parietal peritoneum has benefit over closure of both visceral and parietal peritoneum at LSCS. So closure of visceral and parietal peritoneum may be avoided in LSCS.

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A randomized study comparing non-closure and closure of visceral and parietal peritoneum during cesarean section

Cited by 6 publications

References 9 publications

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

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

Short Term Outcome of Closure or Non-Closure of Peritoneum in Caesarian Section

Advantage of Non-Closure of the Peritoneum at Caesarean Section

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