Gardella Barbara, Dominoni Mattia, Iacobone Anna Daniela, De Silvestri Annalisa, Tinelli Carmine, Bogliolo Stefano, Spinillo Arsenio
Department of Obstetrics and Gynaecology, University of Pavia, Fondazione IRCCS Policlinico, Pavia, Italy.
Department of Obstetrics and Gynaecology, University of Pavia, Fondazione IRCCS Policlinico, Pavia,
Gynecol Obstet Invest. 2018;83(6):521-532. doi: 10.1159/000488241. Epub 2018 Apr 12.
This work analyzes the feasibility and effectiveness of barbed suture during laparoscopic myomectomy.
Eight works have been carefully examined for the meta-analysis from all papers published online until November 2017.
Barbed suture proved to be superior to traditional suture technique in blood loss in laparoscopic myomectomy (Standardized Mean Difference [SMD] -0.650, 95% CI -1.420 to -0.119, p = 0.098, test for heterogenity p < 0.0001, I2 = 95.54%), Hb drop (SMD -1.452, 95% CI -3.590 to 0.687, p = 0.183, test for heterogenity p < 0.0001, I2 = 99.08%), suturing difficulty (SMD -0.638, 95% CI -0.935 to -0.342, p ≤ 0.001, test for heterogenity p = 0.25, I2 = 27.84%), suturing time (SMD -1.197, 95% CI -1.848 to -0.549, p ≤0.001, test for heterogenity p = 0.0001, I2 = 83.30%) and total operative time (SMD -0.687, 95% CI -0.804 to -0.569, p ≤ 0.001, test for heterogenity p = 0.292, I2 = 17.44%). Barbed suture demonstrated to be better in comparison with the control group even with regard to the length of hospitalization (SMD -0.278, 95% CI -0.543 to 0.012, p = 0.040, test for heterogenity p = 0.025, I2 = 61.85%), and to perioperative complications (SMD 0.708, 95% CI 0.503-0.996, p = 0.048, test for heterogenity p = 0.79, I2 = 0%).
Barbed suture significantly facilitates laparoscopic myomectomy by reducing the total operative/suturing time, estimated blood loss/Hb drop, and reduction of perioperative complications.
本研究分析了倒刺缝线在腹腔镜子宫肌瘤切除术中的可行性和有效性。
对截至2017年11月在线发表的所有论文进行了仔细审查，共纳入八项研究进行荟萃分析。
在腹腔镜子宫肌瘤切除术中，倒刺缝线在减少术中出血量方面优于传统缝合技术（标准化均数差[SMD] -0.650，95%可信区间-1.420至-0.119，p = 0.098，异质性检验p < 0.0001，I² = 95.54%）、血红蛋白下降（SMD -1.452，95%可信区间-3.590至0.687，p = 0.183，异质性检验p < 0.0001，I² = 99.08%）、缝合难度（SMD -0.638，95%可信区间-0.935至-0.342，p≤0.001，异质性检验p = 0.25，I² = 27.84%）、缝合时间（SMD -1.197，95%可信区间-1.848至-0.549，p≤0.001，异质性检验p = 0.0001，I² = 83.30%）和总手术时间（SMD -0.687，95%可信区间-0.804至-0.569，p≤0.001，异质性检验p = 0.292，I² = 17.44%）。即使在住院时间方面（SMD -0.278，95%可信区间-0.543至0.012，p = 0.040，异质性检验p = 0.025，I² = 61.85%）以及围手术期并发症方面（SMD 0.708，95%可信区间0.503 - 0.996，p = 0.048，异质性检验p = 0.79，I² = 0%），倒刺缝线与对照组相比也表现更优。
倒刺缝线通过减少总手术/缝合时间、估计失血量/血红蛋白下降以及降低围手术期并发症，显著促进了腹腔镜子宫肌瘤切除术。
