Impact of the number of stapler firings on anastomotic leakage in laparoscopic rectal surgery: a systematic review and meta-analysis
Background Several univariate and multivariate studies have already identified the number of stapler firings for laparoscopic rectal transection for rectal cancer as an independent risk factor for anastomotic leakage. The aim of this study was to perform a systematic review and meta-analysis of the...
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| Veröffentlicht in: | Techniques in coloproctology 2020-09, Vol.24 (9), p.919-925 |
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| creator | Balciscueta, Z. Uribe, N. Caubet, L. López, M. Torrijo, I. Tabet, J. Martín, M. C. |
| description | Background
Several univariate and multivariate studies have already identified the number of stapler firings for laparoscopic rectal transection for rectal cancer as an independent risk factor for anastomotic leakage. The aim of this study was to perform a systematic review and meta-analysis of the anastomotic leakage rate in laparoscopic rectal surgery according to the need of using one or two stapler firings for rectal transection.
Methods
PubMed, Ovid, the Cochrane Library database and ClinicalTrials.gov were searched. All of the statistical analyses were performed using Revman software.
Results
Five studies were included (1267 patients). The overall anastomotic leakage rate was 5.5% [0.7–8.4%]. Anastomotic leak occurred in 3.5% (17/491) of the cases where 1 stapler firing was used versus 6.7% (50/786) of the cases in which 2 firings were needed (50/786). Two stapler firings were significantly associated with an increased risk of anastomotic leakage (OR 2.44, 95% CI 1.34–4.42,
p
= 0.003,
I
2
= 1%).
Conclusions
Our systematic review and meta-analysis suggest that two firings imply a higher rate of anastomotic leak than a single firing after laparoscopic rectal surgery with a double stapling technique. Coloproctologists should strive to reduce the number of linear stapler firings and try to transect the rectum with a single firing. |
| doi_str_mv | 10.1007/s10151-020-02240-7 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2406951130</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2406951130</sourcerecordid><originalsourceid>FETCH-LOGICAL-c375t-1edb503d504bddeb20336a726fa43354c98f61d49407391ffec1899a855b529b3</originalsourceid><addsrcrecordid>eNp9kUFv1DAQhS0EoqXlD3CoLHHpJWDHdpz0hqoClSpxAak3a-JMlpQkTj1O0d754Xh3S5E4cLA8tr95Hr3H2Bsp3kkh7HuSQhpZiFLkVWpR2GfsWMqyLoQ2t8_3tSoqpewRe0V0J4S01siX7EiV2sha2GP263pawCceep6-I5_XqcW4O1GCZcxlP8Rh3hAPM4cZKIUppMHzEeEHbJAPMx9hgRjIhyXfR_QJRk5r3GDcXnDgtKWEE6T948OAP7NOxydMUGTBcUsDnbIXPYyErx_3E_bt49XXy8_FzZdP15cfbgqvrEmFxK41QnVG6LbrsC2FUhXYsupBK2W0b-q-kp1utLCqkX2PXtZNA7UxrSmbVp2w84PuEsP9ipTcNJDHcYQZw0oue1g1RkolMvr2H_QurDHPu6OU1k2VJ8lUeaB8NoAi9m6JwwRx66Rwu4zcISOXM3L7jJzNTWeP0ms7YffU8ieUDKgDQMvOe4x___6P7G-tQZ1d</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2434496503</pqid></control><display><type>article</type><title>Impact of the number of stapler firings on anastomotic leakage in laparoscopic rectal surgery: a systematic review and meta-analysis</title><source>MEDLINE</source><source>SpringerLink Journals - AutoHoldings</source><creator>Balciscueta, Z. ; Uribe, N. ; Caubet, L. ; López, M. ; Torrijo, I. ; Tabet, J. ; Martín, M. C.</creator><creatorcontrib>Balciscueta, Z. ; Uribe, N. ; Caubet, L. ; López, M. ; Torrijo, I. ; Tabet, J. ; Martín, M. C.</creatorcontrib><description>Background
Several univariate and multivariate studies have already identified the number of stapler firings for laparoscopic rectal transection for rectal cancer as an independent risk factor for anastomotic leakage. The aim of this study was to perform a systematic review and meta-analysis of the anastomotic leakage rate in laparoscopic rectal surgery according to the need of using one or two stapler firings for rectal transection.
Methods
PubMed, Ovid, the Cochrane Library database and ClinicalTrials.gov were searched. All of the statistical analyses were performed using Revman software.
Results
Five studies were included (1267 patients). The overall anastomotic leakage rate was 5.5% [0.7–8.4%]. Anastomotic leak occurred in 3.5% (17/491) of the cases where 1 stapler firing was used versus 6.7% (50/786) of the cases in which 2 firings were needed (50/786). Two stapler firings were significantly associated with an increased risk of anastomotic leakage (OR 2.44, 95% CI 1.34–4.42,
p
= 0.003,
I
2
= 1%).
Conclusions
Our systematic review and meta-analysis suggest that two firings imply a higher rate of anastomotic leak than a single firing after laparoscopic rectal surgery with a double stapling technique. Coloproctologists should strive to reduce the number of linear stapler firings and try to transect the rectum with a single firing.</description><identifier>ISSN: 1123-6337</identifier><identifier>EISSN: 1128-045X</identifier><identifier>DOI: 10.1007/s10151-020-02240-7</identifier><identifier>PMID: 32451807</identifier><language>eng</language><publisher>Cham: Springer International Publishing</publisher><subject>Abdominal Surgery ; Anastomosis, Surgical - adverse effects ; Anastomotic Leak - etiology ; Anastomotic Leak - prevention & control ; Anastomotic Leak - surgery ; Colorectal cancer ; Colorectal Surgery ; Gastroenterology ; Humans ; Laparoscopy ; Medicine ; Medicine & Public Health ; Meta-analysis ; Proctology ; Rectal Neoplasms - surgery ; Rectum - surgery ; Review ; Risk Factors ; Surgery ; Surgical Stapling - adverse effects ; Systematic review</subject><ispartof>Techniques in coloproctology, 2020-09, Vol.24 (9), p.919-925</ispartof><rights>Springer Nature Switzerland AG 2020</rights><rights>Springer Nature Switzerland AG 2020.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c375t-1edb503d504bddeb20336a726fa43354c98f61d49407391ffec1899a855b529b3</citedby><cites>FETCH-LOGICAL-c375t-1edb503d504bddeb20336a726fa43354c98f61d49407391ffec1899a855b529b3</cites><orcidid>0000-0002-2318-3693</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s10151-020-02240-7$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s10151-020-02240-7$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32451807$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Balciscueta, Z.</creatorcontrib><creatorcontrib>Uribe, N.</creatorcontrib><creatorcontrib>Caubet, L.</creatorcontrib><creatorcontrib>López, M.</creatorcontrib><creatorcontrib>Torrijo, I.</creatorcontrib><creatorcontrib>Tabet, J.</creatorcontrib><creatorcontrib>Martín, M. C.</creatorcontrib><title>Impact of the number of stapler firings on anastomotic leakage in laparoscopic rectal surgery: a systematic review and meta-analysis</title><title>Techniques in coloproctology</title><addtitle>Tech Coloproctol</addtitle><addtitle>Tech Coloproctol</addtitle><description>Background
Several univariate and multivariate studies have already identified the number of stapler firings for laparoscopic rectal transection for rectal cancer as an independent risk factor for anastomotic leakage. The aim of this study was to perform a systematic review and meta-analysis of the anastomotic leakage rate in laparoscopic rectal surgery according to the need of using one or two stapler firings for rectal transection.
Methods
PubMed, Ovid, the Cochrane Library database and ClinicalTrials.gov were searched. All of the statistical analyses were performed using Revman software.
Results
Five studies were included (1267 patients). The overall anastomotic leakage rate was 5.5% [0.7–8.4%]. Anastomotic leak occurred in 3.5% (17/491) of the cases where 1 stapler firing was used versus 6.7% (50/786) of the cases in which 2 firings were needed (50/786). Two stapler firings were significantly associated with an increased risk of anastomotic leakage (OR 2.44, 95% CI 1.34–4.42,
p
= 0.003,
I
2
= 1%).
Conclusions
Our systematic review and meta-analysis suggest that two firings imply a higher rate of anastomotic leak than a single firing after laparoscopic rectal surgery with a double stapling technique. Coloproctologists should strive to reduce the number of linear stapler firings and try to transect the rectum with a single firing.</description><subject>Abdominal Surgery</subject><subject>Anastomosis, Surgical - adverse effects</subject><subject>Anastomotic Leak - etiology</subject><subject>Anastomotic Leak - prevention & control</subject><subject>Anastomotic Leak - surgery</subject><subject>Colorectal cancer</subject><subject>Colorectal Surgery</subject><subject>Gastroenterology</subject><subject>Humans</subject><subject>Laparoscopy</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Meta-analysis</subject><subject>Proctology</subject><subject>Rectal Neoplasms - surgery</subject><subject>Rectum - surgery</subject><subject>Review</subject><subject>Risk Factors</subject><subject>Surgery</subject><subject>Surgical Stapling - adverse effects</subject><subject>Systematic review</subject><issn>1123-6337</issn><issn>1128-045X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kUFv1DAQhS0EoqXlD3CoLHHpJWDHdpz0hqoClSpxAak3a-JMlpQkTj1O0d754Xh3S5E4cLA8tr95Hr3H2Bsp3kkh7HuSQhpZiFLkVWpR2GfsWMqyLoQ2t8_3tSoqpewRe0V0J4S01siX7EiV2sha2GP263pawCceep6-I5_XqcW4O1GCZcxlP8Rh3hAPM4cZKIUppMHzEeEHbJAPMx9hgRjIhyXfR_QJRk5r3GDcXnDgtKWEE6T948OAP7NOxydMUGTBcUsDnbIXPYyErx_3E_bt49XXy8_FzZdP15cfbgqvrEmFxK41QnVG6LbrsC2FUhXYsupBK2W0b-q-kp1utLCqkX2PXtZNA7UxrSmbVp2w84PuEsP9ipTcNJDHcYQZw0oue1g1RkolMvr2H_QurDHPu6OU1k2VJ8lUeaB8NoAi9m6JwwRx66Rwu4zcISOXM3L7jJzNTWeP0ms7YffU8ieUDKgDQMvOe4x___6P7G-tQZ1d</recordid><startdate>20200901</startdate><enddate>20200901</enddate><creator>Balciscueta, Z.</creator><creator>Uribe, N.</creator><creator>Caubet, L.</creator><creator>López, M.</creator><creator>Torrijo, I.</creator><creator>Tabet, J.</creator><creator>Martín, M. C.</creator><general>Springer International Publishing</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-2318-3693</orcidid></search><sort><creationdate>20200901</creationdate><title>Impact of the number of stapler firings on anastomotic leakage in laparoscopic rectal surgery: a systematic review and meta-analysis</title><author>Balciscueta, Z. ; Uribe, N. ; Caubet, L. ; López, M. ; Torrijo, I. ; Tabet, J. ; Martín, M. C.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c375t-1edb503d504bddeb20336a726fa43354c98f61d49407391ffec1899a855b529b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Abdominal Surgery</topic><topic>Anastomosis, Surgical - adverse effects</topic><topic>Anastomotic Leak - etiology</topic><topic>Anastomotic Leak - prevention & control</topic><topic>Anastomotic Leak - surgery</topic><topic>Colorectal cancer</topic><topic>Colorectal Surgery</topic><topic>Gastroenterology</topic><topic>Humans</topic><topic>Laparoscopy</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Meta-analysis</topic><topic>Proctology</topic><topic>Rectal Neoplasms - surgery</topic><topic>Rectum - surgery</topic><topic>Review</topic><topic>Risk Factors</topic><topic>Surgery</topic><topic>Surgical Stapling - adverse effects</topic><topic>Systematic review</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Balciscueta, Z.</creatorcontrib><creatorcontrib>Uribe, N.</creatorcontrib><creatorcontrib>Caubet, L.</creatorcontrib><creatorcontrib>López, M.</creatorcontrib><creatorcontrib>Torrijo, I.</creatorcontrib><creatorcontrib>Tabet, J.</creatorcontrib><creatorcontrib>Martín, M. C.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Techniques in coloproctology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Balciscueta, Z.</au><au>Uribe, N.</au><au>Caubet, L.</au><au>López, M.</au><au>Torrijo, I.</au><au>Tabet, J.</au><au>Martín, M. C.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Impact of the number of stapler firings on anastomotic leakage in laparoscopic rectal surgery: a systematic review and meta-analysis</atitle><jtitle>Techniques in coloproctology</jtitle><stitle>Tech Coloproctol</stitle><addtitle>Tech Coloproctol</addtitle><date>2020-09-01</date><risdate>2020</risdate><volume>24</volume><issue>9</issue><spage>919</spage><epage>925</epage><pages>919-925</pages><issn>1123-6337</issn><eissn>1128-045X</eissn><abstract>Background
Several univariate and multivariate studies have already identified the number of stapler firings for laparoscopic rectal transection for rectal cancer as an independent risk factor for anastomotic leakage. The aim of this study was to perform a systematic review and meta-analysis of the anastomotic leakage rate in laparoscopic rectal surgery according to the need of using one or two stapler firings for rectal transection.
Methods
PubMed, Ovid, the Cochrane Library database and ClinicalTrials.gov were searched. All of the statistical analyses were performed using Revman software.
Results
Five studies were included (1267 patients). The overall anastomotic leakage rate was 5.5% [0.7–8.4%]. Anastomotic leak occurred in 3.5% (17/491) of the cases where 1 stapler firing was used versus 6.7% (50/786) of the cases in which 2 firings were needed (50/786). Two stapler firings were significantly associated with an increased risk of anastomotic leakage (OR 2.44, 95% CI 1.34–4.42,
p
= 0.003,
I
2
= 1%).
Conclusions
Our systematic review and meta-analysis suggest that two firings imply a higher rate of anastomotic leak than a single firing after laparoscopic rectal surgery with a double stapling technique. Coloproctologists should strive to reduce the number of linear stapler firings and try to transect the rectum with a single firing.</abstract><cop>Cham</cop><pub>Springer International Publishing</pub><pmid>32451807</pmid><doi>10.1007/s10151-020-02240-7</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0002-2318-3693</orcidid></addata></record> |
| fulltext | fulltext |
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| ispartof | Techniques in coloproctology, 2020-09, Vol.24 (9), p.919-925 |
| issn | 1123-6337 1128-045X |
| language | eng |
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| source | MEDLINE; SpringerLink Journals - AutoHoldings |
| subjects | Abdominal Surgery Anastomosis, Surgical - adverse effects Anastomotic Leak - etiology Anastomotic Leak - prevention & control Anastomotic Leak - surgery Colorectal cancer Colorectal Surgery Gastroenterology Humans Laparoscopy Medicine Medicine & Public Health Meta-analysis Proctology Rectal Neoplasms - surgery Rectum - surgery Review Risk Factors Surgery Surgical Stapling - adverse effects Systematic review |
| title | Impact of the number of stapler firings on anastomotic leakage in laparoscopic rectal surgery: a systematic review and meta-analysis |
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