Peritoneal closure--to close or not to close.
Peritoneal closure is a controversial issue among obstetricians and gynaecologists. This article reappraises the issue of peritoneal closure. We conducted a thorough literature search using Medline, Pubmed and Embase as well as a hand-search for all references quoted in the relevant papers. The routine non-closure of the peritoneum reduces operation time by an average of 6 min. Most studies showed no difference in the other outcome measures including infection/febrile episodes, analgesic/anaesthetics requirement, bowel function restoration, post-operative stay and adhesion formation. There are insufficient data concerning adhesion formation. In conclusion, apart from a slightly shorter operation time associated with non-closure of the peritoneum, many studies showed no difference in short-term morbidity in the closure and the non-closure group. More studies are needed to examine the long-term morbidity associated with the closure or the non-closure of the peritoneum.
Cheong
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YC
The Jessop Hospital for Women, Leavygreave Road, Sheffield S3 7RE, UK. yingcheong@hotmail.com
Bajekal
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N
Li
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D000698:Analgesia; D000758:Anesthesia; D005260:Female; D005334:Fever / Q000453:epidemiology; D013509:Gynecologic Surgical Procedures / Q000379:methods*; D006801:Humans; D007239:Infections / Q000453:epidemiology; D007422:Intestines / Q000502:physiology; D013513:Obstetric Surgical Procedures / Q000379:methods*; D010537:Peritoneum / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology; D013997:Time Factors; D000267:Tissue Adhesions / Q000453:epidemiology