PDF(Pubmed)
Abstract：
OBJECTIVE: One of the most challenging tasks in laparoscopic gynecological surgeries is suturing. Knotless barbed sutures are intended to enable faster suturing and hemostasis. We carried out a meta-analysis to compare the efficacy and safety of V-Loc™ barbed sutures (VBS) with conventional sutures (CS) in gynecological surgeries.
METHODS: We systematically searched PubMed and EMBASE for studies published between 2010 and September 2021 comparing VBS to CS for OB/GYN procedures. All comparative studies were included. Primary analysis and subgroup analyses for the different surgery and suturing types were performed. Primary outcomes were operation time and suture time; secondary outcomes included post-operative complications, surgical site infections, estimated blood loss, length of stay, granulation tissue formation, and surgical difficulty. Results were calculated as weighted mean difference (WMD) or risk ratio (RR) and 95% confidence intervals (CI) with a random effects model, and a sensitivity analysis for study quality, study size, and outlier results was performed. PROSPERO registration: CRD42022363187.
RESULTS: In total, 25 studies involving 4452 women undergoing hysterectomy, myomectomy, or excision of endometrioma. VBS were associated with a reduction in operation time (WMD - 17.08 min; 95% CI - 21.57, - 12.59), suture time (WMD - 5.39 min; 95% CI - 7.06, - 3.71), surgical site infection (RR 0.26; 95% CI 0.09, 0.78), estimated blood loss (WMD - 44.91 ml; 95% CI - 66.01, - 23.81), granulation tissue formation (RR 0.48; 95% CI 0.25, 0.89), and surgical difficulty (WMD - 1.98 VAS score; 95% CI - 2.83, - 1.13). No difference between VBS and CS was found regarding total postoperative complications or length of stay. Many of the outcomes showed high heterogeneity, likely due to the inclusion of different surgery types and comparators. Most results were shown to be robust in the sensitivity analysis except for the reduction in granulation tissue formation.
CONCLUSIONS: This meta-analysis indicates that V-Loc™ barbed sutures are safe and effective in gynecological surgeries as they reduce operation time, suture time, blood loss, infections, and surgical difficulty without increasing post-operative complications or length of stay compared to conventional sutures.
METHODS: We systematically searched PubMed and EMBASE for studies published between 2010 and September 2021 comparing VBS to CS for OB/GYN procedures. All comparative studies were included. Primary analysis and subgroup analyses for the different surgery and suturing types were performed. Primary outcomes were operation time and suture time; secondary outcomes included post-operative complications, surgical site infections, estimated blood loss, length of stay, granulation tissue formation, and surgical difficulty. Results were calculated as weighted mean difference (WMD) or risk ratio (RR) and 95% confidence intervals (CI) with a random effects model, and a sensitivity analysis for study quality, study size, and outlier results was performed. PROSPERO registration: CRD42022363187.
RESULTS: In total, 25 studies involving 4452 women undergoing hysterectomy, myomectomy, or excision of endometrioma. VBS were associated with a reduction in operation time (WMD - 17.08 min; 95% CI - 21.57, - 12.59), suture time (WMD - 5.39 min; 95% CI - 7.06, - 3.71), surgical site infection (RR 0.26; 95% CI 0.09, 0.78), estimated blood loss (WMD - 44.91 ml; 95% CI - 66.01, - 23.81), granulation tissue formation (RR 0.48; 95% CI 0.25, 0.89), and surgical difficulty (WMD - 1.98 VAS score; 95% CI - 2.83, - 1.13). No difference between VBS and CS was found regarding total postoperative complications or length of stay. Many of the outcomes showed high heterogeneity, likely due to the inclusion of different surgery types and comparators. Most results were shown to be robust in the sensitivity analysis except for the reduction in granulation tissue formation.
CONCLUSIONS: This meta-analysis indicates that V-Loc™ barbed sutures are safe and effective in gynecological surgeries as they reduce operation time, suture time, blood loss, infections, and surgical difficulty without increasing post-operative complications or length of stay compared to conventional sutures.
摘要：
目的：腹腔镜妇科手术中最具挑战性的任务之一是缝合。无结带刺缝合线旨在实现更快的缝合和止血。我们进行了一项荟萃分析，以比较V-Loc™倒刺缝线（VBS）与常规缝线（CS）在妇科手术中的疗效和安全性。
方法：我们系统地检索了PubMed和EMBASE在2010年至2021年9月期间发表的比较VBS与CS的OB/GYN程序的研究。包括所有比较研究。对不同手术和缝合类型进行了初步分析和亚组分析。主要结果为手术时间和缝合时间；次要结果包括术后并发症，手术部位感染,估计失血量,逗留时间,肉芽组织形成，和手术困难。使用随机效应模型将结果计算为加权平均差（WMD）或风险比（RR）和95％置信区间（CI）。和研究质量的敏感性分析，研究规模，并进行异常结果。PROSPERO注册：CRD42022363187。
结果：总计，25项研究涉及4452名接受子宫切除术的妇女，子宫肌瘤切除术,或切除子宫内膜瘤.VBS与手术时间的减少相关(WMD-17.08分钟;95%CI-21.57,-12.59),缝合时间（WMD-5.39分钟；95%CI-7.06，-3.71），手术部位感染（RR0.26；95%CI0.09，0.78），估计失血量（WMD-44.91ml；95%CI-66.01，-23.81），肉芽组织形成（RR0.48；95%CI0.25，0.89），和手术困难（WMD-1.98VAS评分；95%CI-2.83，-1.13）。在术后总并发症或住院时间方面，VBS和CS之间没有差异。许多结果显示出高度异质性，可能是由于包括不同的手术类型和比较。除了肉芽组织形成的减少外，大多数结果在敏感性分析中都是可靠的。
结论：这项荟萃分析表明，V-Loc™倒刺缝合在妇科手术中是安全有效的，因为它们缩短了手术时间，缝合时间,失血,感染,与传统缝线相比，在不增加术后并发症或住院时间的情况下，手术困难。
方法：我们系统地检索了PubMed和EMBASE在2010年至2021年9月期间发表的比较VBS与CS的OB/GYN程序的研究。包括所有比较研究。对不同手术和缝合类型进行了初步分析和亚组分析。主要结果为手术时间和缝合时间；次要结果包括术后并发症，手术部位感染,估计失血量,逗留时间,肉芽组织形成，和手术困难。使用随机效应模型将结果计算为加权平均差（WMD）或风险比（RR）和95％置信区间（CI）。和研究质量的敏感性分析，研究规模，并进行异常结果。PROSPERO注册：CRD42022363187。
结果：总计，25项研究涉及4452名接受子宫切除术的妇女，子宫肌瘤切除术,或切除子宫内膜瘤.VBS与手术时间的减少相关(WMD-17.08分钟;95%CI-21.57,-12.59),缝合时间（WMD-5.39分钟；95%CI-7.06，-3.71），手术部位感染（RR0.26；95%CI0.09，0.78），估计失血量（WMD-44.91ml；95%CI-66.01，-23.81），肉芽组织形成（RR0.48；95%CI0.25，0.89），和手术困难（WMD-1.98VAS评分；95%CI-2.83，-1.13）。在术后总并发症或住院时间方面，VBS和CS之间没有差异。许多结果显示出高度异质性，可能是由于包括不同的手术类型和比较。除了肉芽组织形成的减少外，大多数结果在敏感性分析中都是可靠的。
结论：这项荟萃分析表明，V-Loc™倒刺缝合在妇科手术中是安全有效的，因为它们缩短了手术时间，缝合时间,失血,感染,与传统缝线相比，在不增加术后并发症或住院时间的情况下，手术困难。
