Barbed versus conventional thread used in laparoscopic gastric bypass: a systematic review and meta-analysis
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SYSTEMATIC REVIEWS AND META-ANALYSES
Barbed versus conventional thread used in laparoscopic gastric bypass: a systematic review and meta-analysis Mohamed Ali Chaouch 1
&
Tarek Kellil 1 & Sahbi Khaled Taieb 1 & Khadija Zouari 1
Received: 23 June 2020 / Accepted: 25 August 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Introduction Hand-sewn gastrointestinal anastomosis during laparoscopic gastric bypass (GBP) could be performed using the conventional multifilament suture (CS) or a barbed suture (BS). This systematic review with meta-analysis aimed to assess the advantages and disadvantages of these two anastomosis alternatives. Methods Bibliographic search for relevant studies was performed, according to the PRISMA guidelines, to perform the systematic review with meta-analysis. RevMan was applied to analyze the data using the random effects size. Results Eight studies were eligible for analysis including 26,340 patients. These patients underwent a single gastric bypass or Roux-en-Y gastric bypass. According to the available data from this systematic review with meta-analysis, BS in GBP ensures similar morbidity rate (OR = 1.04, 95% CI: 0.82 to 1.31, p = 0.74) with shorter operative time (MD = − 7.90, 95% CI: − 12.95 to − 2.84, p = 0.002). BS is similar to CS in terms of anastomotic leak (OR: 1.25, 95% CI: 0.90 to 1.73, p = 0.19), stricture (OR: 0.89, 95% CI: 0.32 to 2.44, p = 0.82), bleeding (OR: 0.62, 95% CI: 0.20 to 1.86, p = 0.39), and hospital stay (MD: 0.04, 95% CI: − 0.28 to 1.86, p = 0.81). On the other way, BS is cheaper than CS. Conclusion The majority of studies were retrospectives. One study included the large majority of retained patients; thus then, this comparison should be interpreted with caution. BS and CS in gastrointestinal anastomosis during GBP are feasible and safe. BS is faster and cheaper with similar postoperative outcomes. Keywords Barbed suture . Conventional suture . Gastric bypass . Roux-en-Y gastric bypass . Single anastomosis gastric bypass . Anastomosis
Introduction Gastric bypass (GBP) procedure is one of the most frequent bariatric procedures used [1]. Its efficacy in terms of weight loss and comorbidity remission is widely acknowledged [2]. Since its first description by Mason in 1969 [3], this procedure has been modified over time. Currently, there is no consensus on the ideal GBP. One of the technical variations is performing the gastrointestinal anastomosis (GIA) to facilitate this procedure and reduce operative time. However, few alternatives are available to surgeons during the critical steps of gastrojejunal anastomosis (GJA) and jejunojejunal
* Mohamed Ali Chaouch [email protected] 1
Department of Digestive Surgery, Fattouma Bourguiba Hospital, Monastir University, Monastir, Tunisia
anastomosis (JJA) for the Roux-en-Y gastric bypass (RYGB) or GJA for single anastomosis gastric bypass (SAGB). Currently, three techniques are employed: handsewn, linear-stapled, and circular-stapled suturing [4]. According to some studies, hand-sewn
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