Volume 10, Issue 4 (2025)
SJMR 2025, 10(4): 209-225 |
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Shafti1 V, Azarboo A, Javidan A. Clinical Outcomes and Complications of Extraperitoneal Caesarean Section: A Systematic Review and Network Meta-Analysis. SJMR 2025; 10 (4) : 7
URL: http://saremjrm.com/article-1-384-en.html
URL: http://saremjrm.com/article-1-384-en.html
1- School of Medicine, Tonekabon Branch, Islamic Azad University, Tonekabon, Iran.
2- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
2- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
Abstract: (173 Views)
Background: Various cesarean delivery approaches have been developed to accelerate postpartum recovery and reduce perioperative and postoperative complications. The aim of this study was to compare the clinical outcomes and complications of ECS and TCS for cesarean delivery. Additionally, we investigated different techniques employed in ECS itself to find the best method of CS.
Methods: A PRISMA-guided systematic search was conducted on electronic databases to identify studies from 1945 to 2023. Studies comparing extraperitoneal cesarean section (ECS) and transperitoneal cesarean section (TCS) for cesarean delivery constituted the included population. Observational and RCT studies were included, with a focus on surgical outcomes, complications, and postoperative recovery. The quality of manuscripts was assessed using the CONSORT and Newcastle-Ottawa scales. Hedges' g standardized mean differences (SMD) and Mantel-Haenszel risk ratio (RR) were used for data synthesis. Network meta-analysis was also performed to compare ECS techniques.
Results: A systematic review and meta-analysis of 698 potential studies on extraperitoneal Caesarean sections (ECS) and transperitoneal cesarean sections (TCS) found no significant difference in total operation time. However, the French AmbUlatory Cesarean Section (FAUCS) method showed longer operation times, while classical paravesical ECS showed shorter times. ECS patients experienced greater blood loss but no significant difference in hemoglobin change. ECS patients were associated with a higher risk of intra-operative vomiting and nausea, while TCS patients reported higher post-operative pain levels. ECS patients had a faster recovery of gastrointestinal function, but the risk of urinary tract infection was comparable between ECS and TCS. When considering RCTs, CONSORT indicated variations in the completeness and quality of reporting in these trials. For the observational studies, the majority received scores of 8 or 9, demonstrating a consistent and relatively high level of methodological quality in these study designs.
Conclusions: This update provides reproductive clinicians and scientists with valuable insights into the clinical outcomes and complications associated with extraperitoneal cesarean sections. By comparing different approaches and their effects on surgical outcomes, pain management, and complications, this study informs clinical practice, helping clinicians make more informed decisions and potentially improve patient care.
Methods: A PRISMA-guided systematic search was conducted on electronic databases to identify studies from 1945 to 2023. Studies comparing extraperitoneal cesarean section (ECS) and transperitoneal cesarean section (TCS) for cesarean delivery constituted the included population. Observational and RCT studies were included, with a focus on surgical outcomes, complications, and postoperative recovery. The quality of manuscripts was assessed using the CONSORT and Newcastle-Ottawa scales. Hedges' g standardized mean differences (SMD) and Mantel-Haenszel risk ratio (RR) were used for data synthesis. Network meta-analysis was also performed to compare ECS techniques.
Results: A systematic review and meta-analysis of 698 potential studies on extraperitoneal Caesarean sections (ECS) and transperitoneal cesarean sections (TCS) found no significant difference in total operation time. However, the French AmbUlatory Cesarean Section (FAUCS) method showed longer operation times, while classical paravesical ECS showed shorter times. ECS patients experienced greater blood loss but no significant difference in hemoglobin change. ECS patients were associated with a higher risk of intra-operative vomiting and nausea, while TCS patients reported higher post-operative pain levels. ECS patients had a faster recovery of gastrointestinal function, but the risk of urinary tract infection was comparable between ECS and TCS. When considering RCTs, CONSORT indicated variations in the completeness and quality of reporting in these trials. For the observational studies, the majority received scores of 8 or 9, demonstrating a consistent and relatively high level of methodological quality in these study designs.
Conclusions: This update provides reproductive clinicians and scientists with valuable insights into the clinical outcomes and complications associated with extraperitoneal cesarean sections. By comparing different approaches and their effects on surgical outcomes, pain management, and complications, this study informs clinical practice, helping clinicians make more informed decisions and potentially improve patient care.
Article number: 7
Article Type: Original Research |
Subject:
Childbirth
Received: 2026/01/6 | Accepted: 2026/02/14 | Published: 2026/03/12
Received: 2026/01/6 | Accepted: 2026/02/14 | Published: 2026/03/12
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