Tao Lan1, Shi-Yu Hu2, Xin-Jian Yang3, Yang Chen4, Yi-Yan Qiu1, Wei-Zhuang Guo1, Jian-Ze Lin1, Kai Ren1. 1. Department of Spine Surgery, Shenzhen Second People's Hospital, The First Affiliated Hospital of Shenzhen University, Shenzhen, 518035, Guangdong, People's Republic of China. 2. Department of Neurology, Shenzhen Second People's Hospital, The First Affiliated Hospital of Shenzhen University, Shenzhen, 518035, Guangdong, People's Republic of China. 3. Department of Spine Surgery, Shenzhen Second People's Hospital, The First Affiliated Hospital of Shenzhen University, Shenzhen, 518035, Guangdong, People's Republic of China. 275305207@qq.com. 4. Department of Spine Surgery, Shenzhen Second People's Hospital, The First Affiliated Hospital of Shenzhen University, Shenzhen, 518035, Guangdong, People's Republic of China. drchenyang@163.com.
Abstract
OBJECTIVE: The purpose of this meta-analysis of randomized controlled trials (RCTs) and non-RCTs was to gather data to evaluate the efficacy and safety of bipolar sealer versus standard electrocautery in the management of spinal disease. METHODS: The electronic databases including Embase, PubMed and Cochrane library were searched to identify relevant studies published from the time of the establishment of these databases up to January 2017. The primary outcomes were total blood loss, requirement of transfusion (rate and amount), and operation time. The secondary outcomes were length of hospital stay and postoperative wound infection. Data analysis was conducted with RevMan 5.3 software. RESULTS: A total of five studies involving 500 patients (261 patients in the BS group and 239 in the control group) were included in the meta-analysis. The pooled results revealed that application of bipolar sealer could decrease the total blood loss in spine surgery [WMD = -467.49, 95% CI (685.47 to -249.51); p < 0.05; I 2 = 91%]. Compared with standard electrocautery, bipolar sealer was associated with lower rates of need for transfusion [OR = 0.30, 95% CI (0.16-0.55), p < 0.05; I 2 = 0%]. In addition, patients in the BS group were likely to receive less amount of blood transfusion compared with patients in the control group[WMD = -0.73, 95% CI (-1.37 to -0.09), p < 0.05; I 2 = 76%]. The mean operative time was shorter in the BS groups compared with the control group [SMD = -0.36, 95% CI (-0.60 to -0.13), p < 0.05; I 2 = 0%]. There was no significant difference in terms of length of hospital stay [WMD = -0.73, 95% CI (-1.96 to 0.51), p = 0.25; I 2 = 67%] and postoperative wound infection [OR = 0.88, 95% CI (0.31-2.48), p = 0.81; I 2 = 0.0%] between both groups. CONCLUSIONS: The available evidence suggests that bipolar sealer is superior to standard electrocautery with less blood loss, shorter operation time and less transfusion requirement. There is no significant difference between both groups regarding length of hospitalization and wound infection. Hence, bipolar sealer is recommended in spine surgery. Because of the limitation of our study, more well-designed RCTs with large sample are required to provide further evidence of safety and efficacy between bipolar sealer and standard electrocautery in the treatment of spinal disease.
OBJECTIVE: The purpose of this meta-analysis of randomized controlled trials (RCTs) and non-RCTs was to gather data to evaluate the efficacy and safety of bipolar sealer versus standard electrocautery in the management of spinal disease. METHODS: The electronic databases including Embase, PubMed and Cochrane library were searched to identify relevant studies published from the time of the establishment of these databases up to January 2017. The primary outcomes were total blood loss, requirement of transfusion (rate and amount), and operation time. The secondary outcomes were length of hospital stay and postoperative wound infection. Data analysis was conducted with RevMan 5.3 software. RESULTS: A total of five studies involving 500 patients (261 patients in the BS group and 239 in the control group) were included in the meta-analysis. The pooled results revealed that application of bipolar sealer could decrease the total blood loss in spine surgery [WMD = -467.49, 95% CI (685.47 to -249.51); p < 0.05; I 2 = 91%]. Compared with standard electrocautery, bipolar sealer was associated with lower rates of need for transfusion [OR = 0.30, 95% CI (0.16-0.55), p < 0.05; I 2 = 0%]. In addition, patients in the BS group were likely to receive less amount of blood transfusion compared with patients in the control group[WMD = -0.73, 95% CI (-1.37 to -0.09), p < 0.05; I 2 = 76%]. The mean operative time was shorter in the BS groups compared with the control group [SMD = -0.36, 95% CI (-0.60 to -0.13), p < 0.05; I 2 = 0%]. There was no significant difference in terms of length of hospital stay [WMD = -0.73, 95% CI (-1.96 to 0.51), p = 0.25; I 2 = 67%] and postoperative wound infection [OR = 0.88, 95% CI (0.31-2.48), p = 0.81; I 2 = 0.0%] between both groups. CONCLUSIONS: The available evidence suggests that bipolar sealer is superior to standard electrocautery with less blood loss, shorter operation time and less transfusion requirement. There is no significant difference between both groups regarding length of hospitalization and wound infection. Hence, bipolar sealer is recommended in spine surgery. Because of the limitation of our study, more well-designed RCTs with large sample are required to provide further evidence of safety and efficacy between bipolar sealer and standard electrocautery in the treatment of spinal disease.
Entities:
Keywords:
Bipolar sealer; Blood loss; Meta-analysis; Spine surgery
Authors: Steven M Frank; Will J Savage; Jim A Rothschild; Richard J Rivers; Paul M Ness; Sharon L Paul; John A Ulatowski Journal: Anesthesiology Date: 2012-07 Impact factor: 7.892
Authors: Juan C Alvarez; Francisco X Santiveri; Isabel Ramos; Enrique Vela; Lluis Puig; Fernando Escolano Journal: Transfusion Date: 2007-12-07 Impact factor: 3.157
Authors: David A Geller; Allan Tsung; Vivek Maheshwari; Lisa A Rutstein; John J Fung; J Wallis Marsh Journal: HPB (Oxford) Date: 2005 Impact factor: 3.647
Authors: Steven M Frank; Jack O Wasey; Ian M Dwyer; Ziya L Gokaslan; Paul M Ness; Khaled M Kebaish Journal: J Orthop Surg Res Date: 2014-07-05 Impact factor: 2.359
Authors: Christopher Mikhail; Zach Pennington; Paul M Arnold; Darrel S Brodke; Jens R Chapman; Norman Chutkan; Michael D Daubs; John G DeVine; Michael G Fehlings; Daniel E Gelb; George M Ghobrial; James S Harrop; Christian Hoelscher; Fan Jiang; John J Knightly; Brian K Kwon; Thomas E Mroz; Ahmad Nassr; K Daniel Riew; Lali H Sekhon; Justin S Smith; Vincent C Traynelis; Jeffrey C Wang; Michael H Weber; Jefferson R Wilson; Christopher D Witiw; Daniel M Sciubba; Samuel K Cho Journal: Global Spine J Date: 2020-01-06