Department of Bariatric Surgery, University of Montreal, Montreal, H3C 3J7, Canada.
Department of General Surgery, Government Medical College Surat, Surat, 395001, India.
Obes Surg. 2024 Sep;34(9):3324-3334. doi: 10.1007/s11695-024-07382-3. Epub 2024 Jul 30.
Mastering intracorporeal suturing is challenging in the evolution from conventional to laparoscopic bariatric surgery. Among various techniques competing for superiority in overcoming this hurdle, we focus on exploring the potential of barbed sutures through a meta-analysis that compares outcomes to those of conventional non-barbed sutures in bariatric surgery.
We conducted a comprehensive search on PubMed, Scopus, and Embase to identify studies comparing barbed sutures with non-barbed sutures in bariatric surgeries, focusing on outcomes such as operative time, suturing time, postoperative complications, and hospital stay. The statistical analysis was carried out using RStudio version 4.3.2. Heterogeneity was assessed using the Cochrane Q test and I statistics.
Incorporating data from 11 studies involving a total of 27,442 patients, including 3,516 in the barbed suture group across various bariatric surgeries, our analysis demonstrates a significant reduction in suturing time (mean difference -4.87; 95% CI -8.43 to -1.30; p < 0.01; I = 99%) associated with the use of barbed sutures. Specifically, in Roux-en-Y gastric bypass, we observed a significant decrease in operative time (mean difference -12.11; 95% CI -19.27 to -4.95; p < 0.01; I = 93%). Subgroup analyses and leave-one-out analyses consistently supported these findings. Furthermore, we found that the mean body mass index did not significantly predict the mean difference in operative time outcome. No significant differences emerged in hospital stay or postoperative complications, including leak, bleeding, stenosis, and bowel obstruction (p > 0.05).
Our study findings address barbed sutures as a potential alternative for laparoscopic intracorporeal suturing in bariatric surgery.
从传统腹腔镜减重手术到腹腔镜减重手术，掌握腔内缝合技术具有挑战性。在各种技术竞争中，我们专注于通过荟萃分析探索使用带倒刺缝线的潜力，该分析比较了带倒刺缝线与传统非带倒刺缝线在减重手术中的结果。
我们在 PubMed、Scopus 和 Embase 上进行了全面搜索，以确定比较带倒刺缝线与非带倒刺缝线在减重手术中的研究，重点关注手术时间、缝合时间、术后并发症和住院时间等结果。使用 RStudio 版本 4.3.2 进行统计分析。使用 Cochrane Q 检验和 I 统计量评估异质性。
纳入 11 项研究的数据，共涉及 27442 名患者，其中 3516 名患者在各种减重手术中使用带倒刺缝线，我们的分析表明，使用带倒刺缝线可显著缩短缝合时间（平均差异-4.87；95%CI-8.43 至-1.30；p<0.01；I=99%）。具体而言，在 Roux-en-Y 胃旁路手术中，我们观察到手术时间显著缩短（平均差异-12.11；95%CI-19.27 至-4.95；p<0.01；I=93%）。亚组分析和逐一剔除分析均支持这些发现。此外，我们发现平均体重指数并不能显著预测手术时间的平均差异结果。住院时间或术后并发症（包括漏、出血、狭窄和肠梗阻）无显著差异（p>0.05）。
我们的研究结果表明，带倒刺缝线可能是减重手术中腹腔镜腔内缝合的一种替代方法。
