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Transperitoneal versus retroperitoneal approach for elective open abdominal aortic aneurysm repair

Overview of attention for article published in Cochrane database of systematic reviews, February 2016
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  • In the top 25% of all research outputs scored by Altmetric
  • Good Attention Score compared to outputs of the same age (79th percentile)
  • Average Attention Score compared to outputs of the same age and source

Mentioned by

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8 tweeters
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2 Facebook pages
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1 Google+ user

Citations

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19 Dimensions

Readers on

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99 Mendeley
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Title
Transperitoneal versus retroperitoneal approach for elective open abdominal aortic aneurysm repair
Published in
Cochrane database of systematic reviews, February 2016
DOI 10.1002/14651858.cd010373.pub2
Pubmed ID
Authors

Bin Ma, Ya-nan Wang, Kuang-yang Chen, Yulong Zhang, Hui Pan, KeHu Yang

Abstract

There has been extensive debate in the surgical literature regarding the optimum surgical access approach to the infrarenal abdominal aorta during an operation to repair an abdominal aortic aneurysm. The published trials comparing retroperitoneal (RP) and transperitoneal (TP) aortic surgery show conflicting results. To assess the effectiveness and safety of the transperitoneal versus retroperitoneal approach for elective open abdominal aortic aneurysm repair on mortality, complications, hospital stay and blood loss. The Cochrane Vascular Trials Search Co-ordinator searched the Cochrane Vascular Specialised Register (last searched May 2015) and CENTRAL (2015, Issue 4) and trials databases (May 2015). The review authors searched the Chinese Biomedical Literature Database and other resources including clinical trials registers. We included randomized controlled trials (RCTs) that assessed the TP approach versus the RP approach for elective open abdominal aortic aneurysm (AAA) repair. We evaluated the outcomes of mortality, complications, intensive care unit (ICU) stay, hospital stay, blood loss, aortic cross-clamp time and operating time. Two review authors independently selected RCTs against the inclusion criteria. We resolved any disagreements by discussion with a third review author. Two review authors independently extracted data from the included trials. We resolved any disagreements by discussion with a third review author. Two review authors independently assessed the risk of bias according to a standard quality checklist provided by Cochrane Vascular. We included four RCTs, with a combined total of 129 participants, that assessed the TP approach versus the RP approach for elective open AAA repair. The overall quality of the evidence was low to very low because of the low methodological quality of the included trials (unclear random sequence generation method and allocation concealment, and no blinding of outcome assessors), small sample sizes, small number of events, high heterogeneity and inconsistency between the included trials, no power calculations and relatively short follow-up. There were no differences between the RP approach and the TP approach regarding mortality (odds ratio (OR) 0.32, 95% CI 0.01 to 8.25; 110 participants; four trials; P = 0.49; I² statistic = 0%; very low quality evidence). However, the RP approach may increase complications, such as hematoma (OR 0.90, 95% CI 0.13 to 6.48; 75 participants; two trials; P = 0.92; very low quality evidence), chronic wound pain (OR 2.20, 95% CI 0.36 to 13.34; 48 participants; one trial; P = 0.39; very low quality evidence) and abdominal wall hernia (OR 10.76, 95% CI 0.55 to 211.78; 48 participants; one trial; P = 0.12; very low quality evidence) compared with the TP approach in the patients for elective open AAA repair, but the confidence intervals (CIs) were wide. The RP approach reduced the blood loss (mean difference (MD) -504.87 mL, 95% CI -779.19 to -230.56; 129 participants; four trials; P = 0.003; very low quality evidence), ICU stay (MD -19.00 hours, 95% CI -31.41 to -6.59; 83 participants; two trials; P = 0.003; low quality evidence) and hospital stay (MD -3.14 days, 95% CI -4.82 to -1.45; 129 participants; four trials; P = 0.0003; low quality evidence). There were no differences between the RP approach and the TP approach regarding aortic cross-clamp time (MD 0.69 mins, 95% CI -7.23 to 8.60; 129 participants; four trials; P = 0.86; very low quality evidence) and operating time (MD -15.94 mins, 95% CI -34.76 to 2.88; 129 participants; four trials; P = 0.10; very low quality evidence). Very low quality evidence from four small RCTs indicates that the RP approach did not have advantages over the TP approach for elective open AAA repair in terms of mortality. Moreover, the RP approach may increase the risk of postoperative wound complications although the CIs were wide.Low quality evidence shows that the RP approach could reduce blood loss, hospital stay and ICU stay compared with the TP approach. Very low quality evidence shows no differences between the RP approach and TP approaches in aortic cross-clamp time and operating time.Further large-scale RCTs of the RP approach versus TP approach for elective open AAA repair are required.

Twitter Demographics

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Mendeley readers

The data shown below were compiled from readership statistics for 99 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Spain 1 1%
Unknown 98 99%

Demographic breakdown

Readers by professional status Count As %
Student > Master 19 19%
Student > Ph. D. Student 11 11%
Student > Bachelor 10 10%
Researcher 9 9%
Other 6 6%
Other 21 21%
Unknown 23 23%
Readers by discipline Count As %
Medicine and Dentistry 47 47%
Nursing and Health Professions 12 12%
Pharmacology, Toxicology and Pharmaceutical Science 3 3%
Agricultural and Biological Sciences 2 2%
Business, Management and Accounting 2 2%
Other 7 7%
Unknown 26 26%

Attention Score in Context

This research output has an Altmetric Attention Score of 7. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 06 June 2017.
All research outputs
#2,543,224
of 14,073,508 outputs
Outputs from Cochrane database of systematic reviews
#5,389
of 10,839 outputs
Outputs of similar age
#68,500
of 339,662 outputs
Outputs of similar age from Cochrane database of systematic reviews
#102
of 189 outputs
Altmetric has tracked 14,073,508 research outputs across all sources so far. Compared to these this one has done well and is in the 81st percentile: it's in the top 25% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 10,839 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 21.6. This one has gotten more attention than average, scoring higher than 50% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 339,662 tracked outputs that were published within six weeks on either side of this one in any source. This one has done well, scoring higher than 79% of its contemporaries.
We're also able to compare this research output to 189 others from the same source and published within six weeks on either side of this one. This one is in the 46th percentile – i.e., 46% of its contemporaries scored the same or lower than it.