Wiggins T, Majid M S, Markar S R, Loy J, Agrawal S, Koak Y
Department of Bariatric Surgery, Homerton University Hospital, London, UK.
Department of Surgery and Cancer, Imperial College London, UK.
Ann R Coll Surg Engl. 2020 Feb;102(2):153-159. doi: 10.1308/rcsann.2019.0106. Epub 2019 Sep 11.
Anastomosis formation constitutes a critical aspect of many gastrointestinal procedures. Barbed suture materials have been adopted by some surgeons to assist in this task. This systematic review and meta-analysis compares the safety and efficacy of barbed suture material for anastomosis formation compared with standard suture materials.
An electronic search of Embase, Medline, Web of Science and Cochrane databases was performed. Weighted mean differences were calculated for effect size of barbed suture material compared with standard material on continuous variables and pooled odds ratios were calculated for discrete variables.
There were nine studies included. Barbed suture material was associated with a significant reduction in overall operative time (WMD: -12.87 (95% CI = -20.16 to -5.58) ( = 0.0005)) and anastomosis time (WMD: -4.28 (95% CI = -6.80 to -1.75) ( = 0.0009)). There was no difference in rates of anastomotic leak (POR: 1.24 (95% CI = 0.89 to 1.71) ( = 0.19)), anastomotic bleeding (POR: 0.80 (95% CI = 0.29 to 2.16) ( = 0.41)), or anastomotic stricture (POR: 0.72 (95% CI = 0.21 to 2.41) ( = 0.59)).
Use of barbed sutures for gastrointestinal anastomosis appears to be associated with shorter overall operative times. There was no difference in rates of complications (including anastomotic leak, bleeding or stricture) compared with standard suture materials.
吻合口形成是许多胃肠道手术的关键环节。一些外科医生采用倒刺缝线材料来辅助完成这项任务。本系统评价和荟萃分析比较了倒刺缝线材料与标准缝线材料在吻合口形成方面的安全性和有效性。
对Embase、Medline、Web of Science和Cochrane数据库进行电子检索。计算倒刺缝线材料与标准材料在连续变量上效应大小的加权平均差，并计算离散变量的合并比值比。
纳入9项研究。倒刺缝线材料与总体手术时间显著缩短相关（加权平均差：-12.87（95%置信区间=-20.16至-5.58）（P=0.0005））和吻合时间显著缩短相关（加权平均差：-4.28（95%置信区间=-6.80至-1.75）（P=0.0009））。吻合口漏发生率（比值比：1.24（95%置信区间=0.89至1.71）（P=0.19））、吻合口出血发生率（比值比：0.80（95%置信区间=0.29至2.16）（P=0.41））或吻合口狭窄发生率（比值比：0.72（95%置信区间=0.21至2.41）（P=0.59））无差异。
在胃肠道吻合术中使用倒刺缝线似乎与缩短总体手术时间相关。与标准缝线材料相比，并发症发生率（包括吻合口漏、出血或狭窄）无差异。
