Wang H, Lu J, Feng J, Wang Z
Third Affiliated Hospital of Soochow University, Jiangsu, China.
Contributed equally.
Ann R Coll Surg Engl. 2017 Sep;99(7):509-514. doi: 10.1308/rcsann.2017.0074.
Introduction This meta-analysis was performed to assess the possible benefits of staple line oversewing during laparoscopic sleeve gastrectomy. Methods A comprehensive search up to February 2017 was conducted on PubMed, the Web of Science™ and Embase™. All eligible studies were included, and the outcomes of staple line bleeding and leak, overall complications and operative time were pooled. Results A total of 7 randomised controlled trials involving 845 patients (428 cases and 417 controls) were analysed. There was no significant difference in staple line bleeding (relative risk [RR]: 0.858, 95% confidence interval [CI]: 0.343-2.143, p=0.742), leak (RR: 0.650, 95% CI: 0.257-1.644, p=0.363) or overall complications (RR: 0.913, 95% CI: 0.621-1.342, p=0.644) between the oversewing group and the patients who did not have oversewing. Oversewing of the staple line was associated with a longer operative time (weighted mean difference: 14.400, 95% CI: 7.198-21.602, p=0.000). Conclusions Oversewing the staple line during laparoscopic sleeve gastrectomy does not decrease the risk of staple line bleeding, leakage or overall complications but it does prolong the operative time.
引言 本荟萃分析旨在评估腹腔镜袖状胃切除术中缝合吻合钉线可能带来的益处。方法 截至2017年2月，在PubMed、科学网™和Embase™上进行了全面检索。纳入所有符合条件的研究，并汇总吻合钉线出血和渗漏、总体并发症及手术时间等结果。结果 共分析了7项随机对照试验，涉及845例患者（428例病例组和417例对照组）。缝合吻合钉线组与未进行缝合的患者在吻合钉线出血（相对危险度[RR]：0.858，95%置信区间[CI]：0.343 - 2.143，p = 0.742）、渗漏（RR：0.650，95% CI：0.257 - 1.644，p = 0.363）或总体并发症（RR：0.913，95% CI：0.621 - 1.342，p = 0.644）方面无显著差异。吻合钉线缝合与较长的手术时间相关（加权平均差：14.400，95% CI：7.198 - 21.602，p = 0.000）。结论 腹腔镜袖状胃切除术中缝合吻合钉线不会降低吻合钉线出血、渗漏或总体并发症的风险，但会延长手术时间。
