Table 3 Rating of quality of evidence with GRADE system
Certainty assessment | Number of patients | Effect | Certainty | Importance | ||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
Number of studies | Study design | Risk of bias | Inconsistency | Indirectness | Imprecision | Other considerations | LH | VH | Relative (95% CI) | Absolute (95% CI) | ||
Overall complications | ||||||||||||
17 | randomised trials | serious† | not serious | not serious | not serious | none | 169/887 (19.1%) | 212/1055 (20.1%) | RR 1.11 (0.85 to 1.45) | 22 more per 1000 (from 30 fewer to 90 more) | ⨁⨁⨁◯ MODERATE | none |
Grade I complications | ||||||||||||
17 | randomised trials | serious† | not serious | not serious | not serious | none | 128/887 (14.4%) | 144/1055 (13.6%) | RR 1.20 (0.90 to 1.61) | 27 more per 1000 (from 14 fewer to 83 more) | ⨁⨁⨁◯ MODERATE | none |
Grade II complications | ||||||||||||
17 | randomised trials | serious† | not serious | not serious | not serious | none | 29/887 (3.3%) | 55/1055 (5.2%) | RR 0.78 (0.49 to 1.24) | 11 fewer per 1000 (from 13 more to 27 fewer) | ⨁⨁⨁◯ MODERATE | none |
Grade III complications | ||||||||||||
17 | randomised trials | serious† | not serious | not serious | not serious | none | 12/887 (1.4%) | 14/1055 (1.3%) | RR 1.03 (0.49 to 2.16) | 0 fewer per 1000 (from 7 fewer to 15 more) | ⨁⨁⨁◯ MODERATE | none |
Urinary tract injuries | ||||||||||||
17 | randomised trials | serious† | not serious | not serious | not serious | none | 9/781 (1.2%) | 10/1020 (1.0%) | RR 1.20 (0.50 to 2.85) | 2 more per 1000 (from 5 fewer to 18 more) | ⨁⨁⨁◯ MODERATE | none |
Operating time | ||||||||||||
18 | randomised trials | serious† | not serious | not serious | not serious | none | 922 | 1089 | – | MD 34.01 h lower (45.54 lower to 24.48 lower) | ⨁⨁⨁◯ MODERATE | none |
Length of hospital stay | ||||||||||||
14 | randomised trials | serious‡ | serious§c | not serious | not serious | none | 636 | 809 | – | MD 6.57 h lower (18.65 lower to 5.5 higher) | ⨁⨁◯◯ LOW | none |
Blood loss | ||||||||||||
16 | randomised trials | serious† | serious§ | not serious | not serious | none | 595 | 598 | – | MD 35.91 mL lower (102.26 lower to 30.43 higher) | ⨁⨁◯◯ LOW | none |
Intraoperative conversion | ||||||||||||
7 | randomised trials | serious† | not serious | not serious | not serious | none | 15/771 (1.9%) | 24/939 (2.6%) | RR 0.94 (0.49 to 1.81) | 2 fewer per 1000 (from 13 fewer to 21 more) | ⨁⨁⨁◯ MODERATE | none |
Recuperation | ||||||||||||
4 | randomised trials | serious‡ | serious§ | not serious | not serious | none | 130 | 130 | – | MD 0.66 days higher (0.77 lower to 0.9 higher) | ⨁⨁◯◯ LOW | none |
Pain on day of surgery (assessed with: Visual analogue scale) | ||||||||||||
5 | randomised trials | serious† | not serious | not serious | not serious | none | 325 | 491 | – | MD 0.8 higher (0.08 lower to 1.68 higher) | ⨁⨁⨁◯ MODERATE | none |
Pain at 24 h after surgery (assessed with: Visual analogue scale) | ||||||||||||
4 | randomised trials | serious† | not serious | not serious | not serious | none | 155 | 157 | – | MD 0.53 lower (0.7 lower to 0.35 lower) | ⨁⨁⨁◯ MODERATE | none |
Pain at 48 h after surgery (assessed with: Visual analogue scale) | ||||||||||||
4 | randomised trials | serious† | not serious | not serious | not serious | none | 295 | 461 | – | MD 0.2 lower (0.61 lower to 0.22 higher) | ⨁⨁⨁◯ MODERATE | none |