Stapled versus handsewn intestinal anastomosis in emergency laparotomy: a systemic review and meta-analysis

Surgery
David N NaumannDouglas M Bowley

Abstract

The optimal technique for gastrointestinal anastomosis remains controversial in emergency laparotomy. The aim of this meta-analysis was to compare outcomes of stapled versus handsewn anastomosis after emergency bowel resection. A systematic review was performed for studies comparing outcomes after emergency laparotomy using stapled versus handsewn anastomosis until July 2014 (PROSPERO registry number: CRD42013006183). The primary endpoint was anastomotic failure, a composite measure of leak, abscess and fistula. Odds ratio (OR; with 95% CI) and weighted mean differences were calculated using meta-analytical techniques. Subgroup analysis was conducted for trauma surgery (TS) and emergency general surgery (EGS) cohorts. Risk of bias for each study was calculated using the Newcastle-Ottawa scale for cohort studies, and Cochrane Collaboration's tool for randomized trials. The final analysis included 7 studies of 1,120 patients, with a total of 1,205 anastomoses. There were 5 TS studies and 2 EGS studies. There were no differences in anastomotic failure between handsewn and stapled techniques on an individual anastomosis level (OR, 1.53; 95% CI, 0.97-2.43; P = .070), or on an individual patient level (OR, 1.44; 95% CI, 0.92-2.25; P ...Continue Reading

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Citations

Sep 18, 2016·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Sami A ChadiSteven D Wexner
Mar 15, 2018·The Journal of Trauma and Acute Care Surgery·Matthew C HernandezMartin D Zielinski
Apr 17, 2018·The Journal of Trauma and Acute Care Surgery·Walter L BifflKaren J Brasel
Nov 27, 2016·Medical Science Monitor : International Medical Journal of Experimental and Clinical Research·Libin YaoHui Wang
Apr 30, 2020·Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland·E EspinS Biondo
Sep 29, 2019·World Journal of Gastroenterology : WJG·Jeremy MeyerFrédéric Ris
Aug 8, 2021·Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland·Joshua Richard BurkeDavid Jayne

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