title: Safety of laparoscopic vs open bariatric surgery: a systematic review and meta-analysis.
abstract: OBJECTIVE
  To perform a systematic review and meta-analysis evaluating the risk of reoperation, wound infection, incisional hernia, anastomotic leak, and all-cause mortality associated with laparoscopic vs open bariatric surgery at a minimum of 12 months' follow-up.
  
  
  METHODS
  We systematically searched the Cochrane Library, EMBASE, and MEDLINE databases through June 1, 2010, for randomized controlled trials comparing laparoscopic with open bariatric surgery.
  
  
  METHODS
  We included all randomized controlled trials that reported weight loss outcomes and complications at a minimum of 12 months' follow-up and had a minimum of 50 patients. We identified 6 randomized controlled trials, which randomized 510 patients.
  
  
  METHODS
  Data were extracted by 2 reviewers on study design, baseline characteristics, and surgical procedure. The outcome data extracted included change in weight and body mass index and the incidence of reoperation, wound infection, incisional hernia, anastomotic leak, and all-cause mortality.
  
  
  RESULTS
  We used random-effects models, which accounted for within-study and between-study variability, to estimate pooled risk ratios (95% CIs). Compared with open surgery, laparoscopic surgery was associated with lower risk of wound infection (relative risk [RR], 0.21; 95% CI, 0.07-0.65) and incisional hernia (RR, 0.11; 95% CI, 0.03-0.35). The risk of reoperation (RR, 1.06; 95% CI, 0.70-1.61), anastomotic leak (RR, 0.64; 95% CI, 0.14-2.95), and all-cause mortality (RR, 0.86; 95% CI, 0.22-3.28) may be similar for laparoscopic and open bariatric surgery.
  
  
  CONCLUSIONS
  Laparoscopic surgery may be a safer treatment than open surgery for patients requiring bariatric surgery.
authors: Divisions of Cardiology and Clinical Epidemiology, Jewish General Hospital/McGill University, Quebec, Canada.
authors: Jennifer
authors: J
authors: Reoch
authors: Salvatore
authors: S
authors: Mottillo
authors: Avi
authors: A
authors: Shimony
authors: Kristian B
authors: KB
authors: Filion
authors: Nicolas V
authors: NV
authors: Christou
authors: Lawrence
authors: L
authors: Joseph
authors: Paul
authors: P
authors: Poirier
authors: Mark J
authors: MJ
authors: Eisenberg
mesh_terms: D050110:Bariatric Surgery / Q000379:methods* / Q000592:standards; D006801:Humans; D010535:Laparoscopy / Q000592:standards*; D007813:Laparotomy / Q000592:standards*; D009767:Obesity, Morbid / Q000601:surgery*; D017751:Safety Management / Q000379:methods*; D016896:Treatment Outcome