目的:在从传统减肥手术到腹腔镜减肥手术的演变过程中,掌握体内缝合是一项挑战。在争夺克服这一障碍的优势的各种技术中,通过一项荟萃分析,我们重点探讨了倒钩缝线的潜力,该荟萃分析比较了传统无倒钩缝线在减肥手术中的结局.
方法:我们对PubMed进行了全面搜索,Scopus,和Embase以确定在减肥手术中比较倒刺缝线和无倒刺缝线的研究,关注手术时间等结果,缝合时间,术后并发症,住院。使用RStudio版本4.3.2进行统计分析。使用CochraneQ检验和I2统计量评估异质性。
结果:纳入11项研究的数据,涉及27,442名患者,包括各种减肥手术的带刺缝合组的3,516人,我们的分析显示,使用倒钩缝线可显著缩短缝合时间(平均差-4.87;95%CI-8.43~-1.30;p<0.01;I2=99%).具体来说,在Roux-en-Y胃旁路术中,我们观察到手术时间显着减少(平均差异-12.11;95%CI-19.27至-4.95;p<0.01;I2=93%)。亚组分析和漏报分析始终支持这些发现。此外,我们发现,平均体重指数并不能显著预测手术时间结局的平均差异.在住院时光或术后并发症方面无明显差别,包括泄漏,出血,狭窄,肠梗阻(p>0.05)。
结论:我们的研究发现将倒刺缝线作为减肥手术中腹腔镜内缝合的潜在替代方法。
OBJECTIVE: 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.
METHODS: 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 I2 statistics.
RESULTS: 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; I2 = 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; I2 = 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).
CONCLUSIONS: Our study findings address barbed sutures as a potential alternative for laparoscopic intracorporeal suturing in bariatric surgery.