Summary of findings for the main comparison. Laparoscopy versus laparotomy for preventing catheter‐related infections in chronic peritoneal dialysis patients.
| Laparoscopy versus laparotomy for preventing catheter‐related infections in chronic peritoneal dialysis patients | |||||
| Patient or population: chronic peritoneal dialysis patients Intervention: laparoscopy Comparison: laparotomy | |||||
| Outcomes | Anticipated absolute effects* (95% CI) | Relative effect (95% CI) | No. of participants or patient‐months (studies) | Certainty of the evidence (GRADE) | |
| Risk with laparotomy | Risk with laparoscopy | ||||
| Peritonitis | 242 per 1,000 | 218 per 1,000 (143 to 327) | RR 0.90 (0.59 to 1.35) | 315 (4) | ⊕⊕⊕⊝ MODERATE 1 |
| Peritonitis rate (patient‐months) | 59 per 1,000 | 52 per 1,000 (23 to 122) | RR 0.89 (0.39 to 2.07) | 375 (1) | ⊕⊝⊝⊝ VERY LOW 2 |
| Exit‐site/tunnel infection | 125 per 1,000 | 125 per 1,000 (54 to 289) | RR 1.00 (0.43 to 2.31) | 270 (3) | ⊕⊕⊝⊝ LOW 3 |
| Catheter removal or replacement | 281 per 1,000 | 337 per 1,000 (216 to 522) | RR 1.20 (0.77 to 1.86) | 167 (3) | ⊕⊕⊝⊝ LOW 3 |
| Technique failure | 293 per 1,000 | 208 per 1,000 (137 to 316) | RR 0.71 (0.47 to 1.08) | 283 (4) | ⊕⊕⊝⊝ LOW 3 |
| Death (all causes) | 140 per 1,000 | 176 per 1,000 (101 to 307) | RR 1.26 (0.72 to 2.20) | 270 (3) | ⊕⊕⊕⊝ MODERATE 1 |
| *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; RR: Risk ratio | |||||
| GRADE Working Group grades of evidence High certainty: We are very confident that the true effect lies close to that of the estimate of the effect Moderate certainty: 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 certainty: Our confidence in the effect estimate is limited: The true effect may be substantially different from the estimate of the effect Very low certainty: We have very little confidence in the effect estimate: The true effect is likely to be substantially different from the estimate of effect | |||||
1 Downgraded one level: suboptimal quality of studies
2 Downgraded two levels: single study with suboptimal quality and imprecision
3 Downgraded two levels: suboptimal quality and imprecision