17. Detailed 'Summary of findings' table: methods of parenchymal transection.
| Outcomes | Illustrative comparative risks* (95% CrI) | Relative effect (95% CrI) | No of participants (studies) | Quality of the evidence (GRADE) | |
| Assumed risk | Corresponding risk | ||||
| Control | Intervention | ||||
| Mortality (perioperative) | |||||
| CUSA vs clamp‐crush method | 23 per 1000 |
6 per 1000 (0 to 54) |
OR 0.24 (0.01 to 2.41) |
172 (2 studies) |
⊕⊝⊝⊝ Very low1,2,3 |
| Radiofrequency dissecting sealer vs clamp‐crush method | 10 per 1000 |
16 per 1000 (4 to 65) |
OR 1.60 (0.43 to 6.7) |
390 (5 studies) |
⊕⊝⊝⊝ Very low1,2,3 |
| Sharp transection method vs clamp‐crush method | There was no mortality in either group. |
82 (1 study) |
⊕⊝⊝⊝ Very low1,2,3 |
||
| Stapler vs clamp‐crush method | 31 per 1000 |
67 per 1000 (12 to 375) |
OR 2.26 (0.39 to 18.93) |
130 (1 study) |
⊕⊝⊝⊝ Very low1,2,3 |
| Hydrojet vs CUSA | 55 per 1000 |
54 per 1000 (9 to 258) |
OR 0.98 (0.16 to 6.04) |
111 (2 studies) |
⊕⊝⊝⊝ Very low1,2,3 |
| Radiofrequency dissecting sealer vs CUSA | 44 per 1000 |
28 per 1000 (3 to 166) |
OR 0.61 (0.07 to 4.28) |
90 (2 studies) |
⊕⊝⊝⊝ Very low1,2,3 |
| Stapler vs CUSA | There was no mortality in either group. |
79 (1 study) |
⊕⊝⊝⊝ Very low1,2,3 |
||
| Radiofrequency dissecting sealer vs hydrojet | 80 per 1000 |
9 per 1000 (0 to 145) |
OR 0.10 (0 to 1.95) |
50 (1 study) |
⊕⊝⊝⊝ Very low1,2,3 |
| Mortality (longest follow‐up) | None of the trials reported this outcome. | ||||
| Serious adverse events (proportion) | |||||
| CUSA vs clamp‐crush method | 93 per 1000 |
31 per 1000 (6 to 110) |
OR 0.31 (0.06 to 1.2) |
172 (2 studies) |
⊕⊝⊝⊝ Very low1,2,3 |
| Radiofrequency dissecting sealer vs clamp‐crush method | 58 per 1000 |
49 per 1000 (15 to 145) |
OR 0.83 (0.24 to 2.74) |
240 (3 studies) |
⊕⊝⊝⊝ Very low1,2,3 |
| Sharp transection method vs clamp‐crush method | 49 per 1000 |
106 per 1000 (20 to 502) |
OR 2.31 (0.39 to 19.69) |
82 (1 study) |
⊕⊝⊝⊝ Very low1,2,3 |
| Hydrojet vs CUSA | 100 per 1000 |
124 per 1000 (61 to 238) |
OR 1.27 (0.58 to 2.81) |
61 (1 study) |
⊕⊝⊝⊝ Very low1,2,3 |
| Radiofrequency dissecting sealer vs CUSA | 50 per 1000 |
30 per 1000 (3 to 180) |
OR 0.58 (0.06 to 4.16) |
40 (1 study) |
⊕⊝⊝⊝ Very low1,2,3 |
| Stapler vs CUSA | 246 per 1000 |
246 per 1000 (6 to 931) |
OR 1.00 (0.02 to 41.22) |
130 (1 study) |
⊕⊝⊝⊝ Very low1,2,3 |
| Serious adverse events (number) | |||||
| CUSA vs clamp‐crush method | 45 per 1000 |
29 per 1000 (3 to 166) |
Rate ratio 0.63 (0.07 to 4.17) |
132 (1 study) |
⊕⊝⊝⊝ Very low1,2,3 |
| Radiofrequency dissecting sealer vs clamp‐crush method | 61 per 1000 |
190 per 1000 (75 to 474) |
Rate ratio 3.64 (1.25 to 13.97) |
130 (2 studies) |
⊕⊕⊝⊝ Low1,2 |
| Hydrojet vs CUSA | 80 per 1000 |
121 per 1000 (20 to 546) |
Rate ratio 1.59 (0.24 to 13.83) |
50 (1 study) |
⊕⊝⊝⊝ Very low1,2,3 |
| Radiofrequency dissecting sealer vs CUSA | 80 per 1000 |
121 per 1000 (20 to 546) |
Rate ratio 1.59 (0.24 to 13.83) |
50 (1 study) |
⊕⊝⊝⊝ Very low1,2,3 |
| Stapler vs CUSA | 180 per 1000 |
230 per 1000 (109 to 424) |
Rate ratio 1.36 (0.56 to 3.36) |
100 (1 study) |
⊕⊝⊝⊝ Very low1,2,3 |
| Radiofrequency dissecting sealer vs hydrojet | 120 per 1000 |
120 per 1000 (23 to 445) |
Rate ratio 1.00 (0.17 to 5.88) |
50 (1 study) |
⊕⊝⊝⊝ Very low1,2,3 |
| Health‐related quality of life (30 days, 3 months) | None of the trials reported this outcome. | ||||
| Health‐related quality of life (maximal follow‐up) | None of the trials reported this outcome. | ||||
| *The basis for the assumed risk is the mean control group proportion. The corresponding risk (and its 95% credible interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CrI). Network meta‐analysis was not performed for any of the outcomes because of the lack of availability of direct and indirect comparisons in the network. CrI: credible intervals; CUSA: cavitron ultrasonic surgical aspirator; OR: odds ratio | |||||
| GRADE Working Group grades of evidence High quality: Further research is very unlikely to change our confidence in the estimate of effect. Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate. Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate. Very low quality: We are very uncertain about the estimate. | |||||
1 Risk of bias was unclear or high in the trial(s) (downgraded by 1 point). 2 Sample size was low (total number of participants fewer than 400 for continuous outcomes and fewer than 300 events in total in both groups for other outcomes) (downgraded by 1 point). 3 Credible intervals spanned no effect and clinically significant effect (20% relative risk reduction for binary outcomes; standardised mean difference of 0.5 for health‐related quality of life) (downgraded by 1 point).