Yifei Lin1, Youlin Long2, Sike Lai3, Yonggang Zhang4, Qiong Guo2, Jin Huang5,6,7, Liang Du8,9. 1. Urology Department, Institute of Urology, Laboratory of Reconstructive Urology, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China. 2. Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University, Chengdu, 610041, People's Republic of China. 3. West China School of Medicine, Sichuan University, Guoxuexiang 37, Chengdu, 610041, Sichuan, China. 4. West China Hospital, Sichuan University, Guoxuexiang 37, Chengdu, 610041, Sichuan, China. 5. Urology Department, Institute of Urology, Laboratory of Reconstructive Urology, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China. michael_huangjin@163.com. 6. Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University, Chengdu, 610041, People's Republic of China. michael_huangjin@163.com. 7. West China Hospital, Sichuan University, Guoxuexiang 37, Chengdu, 610041, Sichuan, China. michael_huangjin@163.com. 8. Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University, Chengdu, 610041, People's Republic of China. 125798620@qq.com. 9. West China Medical Publishers, West China Hospital, Sichuan University, Chengdu, 610041, People's Republic of China. 125798620@qq.com.
Abstract
BACKGROUND: Knotless barbed sutures can eliminate knot tying during the bariatric surgery (BS). Since effects reported on patients and surgeons are ambiguous, this study is determined to identify the effectiveness and safety of knotless barbed suture in BS. METHODS: PubMed, EMBASE, Cochrane Register of Clinical Studies, and ClinicalTrials.gov were searched for randomized controlled trials (RCTs) and cohort studies comparing barbed sutures with conventional sutures in BS (until July 2, 2018). Quality assessment was conducted due to Cochrane's recommendations. Review Manager was applied to analyze the data, and we performed subgroup analyses based on study design type and surgery type. RESULTS: A total of four cohort studies (25,505 patients, low to moderate risk of bias) and four RCTs (1480 patients, low to moderate risk of bias) proved eligible. BS includes laparoscopic Roux-en-Y gastric bypass and laparoscopic sleeve gastrectomy. Comparing to conventional suture, pooling data showed that suture time (MD = - 4.87, 95%CI - 8.82 to - 0.92, P = 0.02) and operative time (MD = - 7.88, 95%CI - 14.10 to - 1.67, P = 0.01) declined significantly in the barbed group. Although no significant change was in the overall postoperative complications and hospital stay, subgroup analysis of RCTs suggested that significantly, fewer bleeding conditions happened in barbed groups. CONCLUSIONS: Although quality of all the studies was relatively moderate and the number of the included studies was limited, the barbed suture may have the potentiality to be an effective and reliable technique and extend the application in other bariatric surgeries. More evidence with randomized design, larger sample sizes, and longer follow-up need to compel validations of this state-of-the-art in the future.
BACKGROUND: Knotless barbed sutures can eliminate knot tying during the bariatric surgery (BS). Since effects reported on patients and surgeons are ambiguous, this study is determined to identify the effectiveness and safety of knotless barbed suture in BS. METHODS: PubMed, EMBASE, Cochrane Register of Clinical Studies, and ClinicalTrials.gov were searched for randomized controlled trials (RCTs) and cohort studies comparing barbed sutures with conventional sutures in BS (until July 2, 2018). Quality assessment was conducted due to Cochrane's recommendations. Review Manager was applied to analyze the data, and we performed subgroup analyses based on study design type and surgery type. RESULTS: A total of four cohort studies (25,505 patients, low to moderate risk of bias) and four RCTs (1480 patients, low to moderate risk of bias) proved eligible. BS includes laparoscopic Roux-en-Y gastric bypass and laparoscopic sleeve gastrectomy. Comparing to conventional suture, pooling data showed that suture time (MD = - 4.87, 95%CI - 8.82 to - 0.92, P = 0.02) and operative time (MD = - 7.88, 95%CI - 14.10 to - 1.67, P = 0.01) declined significantly in the barbed group. Although no significant change was in the overall postoperative complications and hospital stay, subgroup analysis of RCTs suggested that significantly, fewer bleeding conditions happened in barbed groups. CONCLUSIONS: Although quality of all the studies was relatively moderate and the number of the included studies was limited, the barbed suture may have the potentiality to be an effective and reliable technique and extend the application in other bariatric surgeries. More evidence with randomized design, larger sample sizes, and longer follow-up need to compel validations of this state-of-the-art in the future.
Authors: Vito De Blasi; Olivier Facy; Martine Goergen; Virginie Poulain; Luigi De Magistris; Juan Santiago Azagra Journal: Obes Surg Date: 2013-01 Impact factor: 4.129
Authors: Eric A Finkelstein; Olga A Khavjou; Hope Thompson; Justin G Trogdon; Liping Pan; Bettylou Sherry; William Dietz Journal: Am J Prev Med Date: 2012-06 Impact factor: 5.043
Authors: Kevin C Zorn; Quoc-Dien Trinh; Claudio Jeldres; Jan Schmitges; Hugues Widmer; Jean-Baptiste Lattouf; Jesse Sammon; Dan Liberman; Maxine Sun; Marco Bianchi; Pierre I Karakiewicz; Ronald Denis; Gagan Gautam; Assaad El-Hakim Journal: BJU Int Date: 2012-01-05 Impact factor: 5.588
Authors: Giovanni Maconi; Gianluca M Sampietro; Fabrizio Parente; Giovanni Pompili; Antonio Russo; Massimo Cristaldi; Giancarlo Arborio; Sandro Ardizzone; Giovanni Matacena; Angelo Maria Taschieri; Gabriele Bianchi Porro Journal: Am J Gastroenterol Date: 2003-07 Impact factor: 10.864
Authors: Michele Manigrasso; Nunzio Velotti; Federica Calculli; Giovanni Aprea; Katia Di Lauro; Enrico Araimo; Ugo Elmore; Sara Vertaldi; Pietro Anoldo; Mario Musella; Marco Milone; Loredana Maria Sosa Fernandez; Francesco Milone; Giovanni Domenico De Palma Journal: Open Med (Wars) Date: 2019-08-09