Table 2 Certainty assessment of evidence
Quality assessment | No of patients | Effect | Certainty | Importance | ||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
No of studies | Design | Risk of bias | Inconsistency | Indirectness | Imprecision | Other considerations | SEMS | DT | Relative (95% CI) | Absolute | ||
Technical success | ||||||||||||
7 | Randomised trials | Serious1 | No serious inconsistency | No serious indirectness | No serious imprecision | None | 250/276 (90.6%) | 274/277 (98.9%) | OR 0.13 (0.05 to 0.39) | 67 fewer per 1000 (from 16 to 169 fewer) | MODERATE | CRITICAL |
Technical success | ||||||||||||
15 | Observational studies | Serious1 | No serious inconsistency | No serious indirectness | No serious imprecision | None | 618/630 (98.1%) | 526/593 (88.7%) | OR 2.55 (1.30 to 5.02) | 65 more per 1000 (from 24 to 88 more) | VERY LOW | CRITICAL |
Clinical success | ||||||||||||
5 | Randomised trials | Serious1 | No serious inconsistency | No serious indirectness | No serious imprecision | None | 183/210 (87.1%) | 200/210 (95.2%) | OR 0.38 (0.16 to 0.88) | 69 fewer per 1000 (from 6 to 190 fewer) | MODERATE | CRITICAL |
Clinical success | ||||||||||||
15 | Observational studies | Serious1 | No serious inconsistency | No serious indirectness | No serious imprecision | None | 590/620 (95.2%) | 503/583 (86.3%) | OR 3.13 (1.74 to 5.63) | 89 more per 1000 (from 53 to 110 more) | VERY LOW | CRITICAL |
Operation-related perforation | ||||||||||||
2 | Randomised trials | Serious1 | No serious inconsistency | No serious indirectness | Serious3 | None | 1/55 (1.8%) | 0/55 (0%) | OR 3.15 (0.12 to 82.16) | - | LOW | IMPORTANT |
Operation-related perforation | ||||||||||||
12 | Observational studies | Serious1 | No serious inconsistency | No serious indirectness | No serious imprecision | None | 11/585 (1.9%) | 28/548 (5.1%) | OR 0.51 (0.26 to 0.99) | 24 fewer per 1000 (from 0 to 37 fewer) | VERY LOW | IMPORTANT |
Operation-related abdominal pain | ||||||||||||
3 | Observational studies | Serious1 | No serious inconsistency | No serious indirectness | No serious imprecision | None | 8/102 (7.8%) | 16/52 (30.8%) | OR 0.16 (0.05 to 0.5) | 241 fewer per 1000 (from 126 to 286 fewer) | VERY LOW | IMPORTANT |
Device migration | ||||||||||||
8 | Observational studies | Serious1 | No serious inconsistency | No serious indirectness | Serious3 | None | 6/363 (1.7%) | 12/375 (3.2%) | OR 0.56 (0.23 to 1.37) | 14 fewer per 1000 (from 24 fewer to 11 more) | VERY LOW | IMPORTANT |
Intraoperative bleeding | ||||||||||||
7 | Observational studies | Serious1 | Serious2 | No serious indirectness | Serious3 | None | 255 | 285 | - | MD 37.67 lower (62.73 to 12.6 lower) | VERY LOW | IMPORTANT |
Postoperative stoma creation | ||||||||||||
9 | Observational studies | Serious1 | Serious2 | No serious indirectness | No serious imprecision | None | 51/462 (11%) | 132/498 (26.5%) | OR 0.41 (0.23 to 0.73) | 136 fewer per 1000 (from 57 to 188 fewer) | VERY LOW | IMPORTANT |
Postoperative hospital stays | ||||||||||||
13 | Observational studies | Serious1 | Serious2 | No serious indirectness | No serious imprecision | None | 599 | 565 | - | MD 4.47 lower (6.26 to 2.69 lower) | VERY LOW | IMPORTANT |
Postoperative anastomotic leakage | ||||||||||||
5 | Randomised trials | Serious1 | No serious inconsistency | No serious indirectness | Serious3 | None | 3/171 (1.8%) | 2/172 (1.2%) | OR 1.61 (0.25 to 10.34) | 7 more per 1000 (from 9 fewer to 97 more) | LOW | IMPORTANT |
Postoperative anastomotic leakage | ||||||||||||
13 | Observational studies | Serious1 | No serious inconsistency | No serious indirectness | Serious3 | None | 19/585 (3.2%) | 20/534 (3.7%) | OR 1.06 (0.57 to 1.98) | 2 more per 1000 (from 16 fewer to 34 more) | VERY LOW | IMPORTANT |
Postoperative infection | ||||||||||||
7 | Randomised trials | Serious1 | No serious inconsistency | No serious indirectness | Serious3 | None | 10/291 (3.4%) | 9/292 (3.1%) | OR 1.15 (0.44 to 2.99) | 4 more per 1000 (from 17 fewer to 56 more) | LOW | IMPORTANT |
Postoperative infection | ||||||||||||
8 | Observational studies | No serious risk of bias | No serious inconsistency | No serious indirectness | Serious3 | None | 11/246 (4.5%) | 15/253 (5.9%) | OR 0.58 (0.26 to 1.29) | 24 fewer per 1000 (from 43 fewer to 16 more) | VERY LOW | IMPORTANT |
Postoperative 30d mortality | ||||||||||||
7 | Observational studies | Serious1 | No serious inconsistency | No serious indirectness | Serious3 | None | 4/358 (1.1%) | 7/410 (1.7%) | OR 0.62 (0.20 to 1.91) | 6 fewer per 1000 (from 14 fewer to 15 more) | VERY LOW | CRITICAL |
Overall survival | ||||||||||||
6 | Observational studies | No serious risk of bias | No serious inconsistency | No serious indirectness | Serious3 | None | 151/208 (72.6%) | 178/246 (72.4%) | OR 0.91 (0.40 to 2.04) | 19 fewer per 1000 (from 212 fewer to 119 more) | VERY LOW | IMPORTANT |
Recurrence free | ||||||||||||
7 | Observational studies | Serious1 | No serious inconsistency | No serious indirectness | No serious imprecision | None | 205/311 (65.9%) | 226/368 (61.4%) | RR 1.32 (0.81 to 2.17) | 197 more per 1000 (from 117 fewer to 719 more) | VERY LOW | IMPORTANT |
Tumor recurrence | ||||||||||||
4 | Observational studies | Serious1 | No serious inconsistency | No serious indirectness | No serious imprecision | None | 24/143 (16.8%) | 20/78 (25.6%) | RR 0.47 (0.22 to 0.99) | 136 fewer per 1000 (from 3 to 200 fewer) | VERY LOW | IMPORTANT |
Tumor metastasis | ||||||||||||
3 | Observational studies | No serious risk of bias | No serious inconsistency | No serious indirectness | No serious imprecision | None | 19/117 (16.2%) | 12/45 (26.7%) | RR 0.50 (0.16 to 1.62) | 133 fewer per 1000 (from 224 fewer to 165 more) | LOW | IMPORTANT |