Effect of powered circular stapler in colorectal anastomosis after left-sided colic resection: systematic review and meta-analysis.
Anastomotic leak
Colorectal surgery
Left-sided anastomosis
Left-sided colonic resection
Powered circular stapler
Journal
International journal of colorectal disease
ISSN: 1432-1262
Titre abrégé: Int J Colorectal Dis
Pays: Germany
ID NLM: 8607899
Informations de publication
Date de publication:
27 Sep 2024
27 Sep 2024
Historique:
accepted:
18
09
2024
medline:
27
9
2024
pubmed:
27
9
2024
entrez:
27
9
2024
Statut:
epublish
Résumé
Anastomotic leak (AL) remains the most important complication after left-sided colic anastomoses and technical complications during anastomotic construction are responsible of higher leakage incidence. Powered circular stapler (PCS) in colorectal surgery has been introduced in order to reduce technical errors and post-operative complications due to the manual circular stapler (MCS). A systematic review and meta-analysis were performed. An electronic systematic search was performed using Web of Science, PubMed, and Embase of studies comparing PCS and MCS. The incidence of AL, anastomotic bleeding (AB), conversion, and reoperation were assessed. PROSPERO Registration Number: CRD42024512644. Five observational studies were eligible for inclusion reporting on 2379 patients. The estimated pooled Risk Ratios for AL and AB rates following PCS were significantly lower than those observed with MCS (0.44 and 0.23, respectively; both with p < 0.01). Conversion and reoperation rate did not show any significant difference: 0.41 (95% CI 0.09-1.88; p = 0.25) and 0.78 (95% CI 0.33-1.84; p = 0.57); respectively. The use of PCS demonstrates a lower incidence of AL and AB compared to MCS but does not exhibit a discernible influence on reintervention or conversion rates. The call for future randomized clinical trials aims to definitively clarify these issues and contribute to further advancements in refining surgical strategies for left-sided colonic resection.
Identifiants
pubmed: 39331160
doi: 10.1007/s00384-024-04729-1
pii: 10.1007/s00384-024-04729-1
doi:
Types de publication
Journal Article
Systematic Review
Meta-Analysis
Langues
eng
Sous-ensembles de citation
IM
Pagination
152Informations de copyright
© 2024. The Author(s).
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