Velotti Nunzio, Manigrasso Michele, Di Lauro Katia, Vertaldi Sara, Anoldo Pietro, Vitiello Antonio, Milone Francesco, Musella Mario, De Palma Giovanni Domenico, Milone Marco
Department of Advanced Biomedical Sciences, University of Naples "Federico II", Naples, Italy.
Department of Advanced Biomedical Sciences, University of Naples "Federico II", Naples, Italy.
Surgeon. 2022 Apr;20(2):115-122. doi: 10.1016/j.surge.2021.02.011. Epub 2021 Apr 2.
The laparoscopic approach is a very popular technique for many gastrointestinal operations and barbed sutures may improve the difficulties of intracorporeal anastomosis by eliminating the need for knot tying. The aim of this systematic review with a meta-analysis is to explore literature to establish the security profile of barbed suture compared with conventional laparoscopic sutures.
A systematic search was performed in all electronic databases (PubMed, Web of Science, Scopus, EMBASE) and 12 studies were included in the analysis, involving 27,133 patients, whereof 3372 cases (patients undergone barbed suture usage) and 23,761 controls (patients undergone conventional suture usage). We found 3 studies discussing differences between barbed and conventional sutures in colorectal surgery and 8 studies presenting results in bariatric surgery, both in Roux-en-y gastric bypass and Mini Gastric/One Anastomosis Gastric Bypass.
We found comparable rate of leaks, bleedings and stenosis. The meta-regression analysis demonstrated that, both in case of bariatric and colorectal surgery, the demographic characteristic of patients and the oncological features of neoplasms did not impact of these findings. As expected, operative time is significantly shorter when barbed suture is used.
Our analysis on current literature define an acceptable security profile for barbed suture with effective results particularly in terms of shorter operative time.
腹腔镜手术是许多胃肠手术中非常流行的技术，倒刺缝线可通过消除打结的需要来改善体内吻合的困难。本系统评价和荟萃分析的目的是探索文献，以确定倒刺缝线与传统腹腔镜缝线相比的安全性。
在所有电子数据库（PubMed、科学网、Scopus、EMBASE）中进行了系统检索，分析纳入了12项研究，涉及27133例患者，其中3372例（使用倒刺缝线的患者）和23761例对照（使用传统缝线的患者）。我们发现3项研究讨论了结直肠手术中倒刺缝线与传统缝线的差异，8项研究呈现了减重手术的结果，包括Roux-en-y胃旁路手术和迷你胃/单吻合口胃旁路手术。
我们发现渗漏、出血和狭窄的发生率相当。荟萃回归分析表明，在减重手术和结直肠手术中，患者的人口统计学特征和肿瘤的肿瘤学特征均不影响这些结果。正如预期的那样，使用倒刺缝线时手术时间明显更短。
我们对当前文献的分析确定了倒刺缝线可接受的安全性，其效果显著，尤其是在缩短手术时间方面。
