Can a nickel–titanium memory-shape device serve as a substitute for the stapler in gastrointestinal anastomosis? A systematic review and meta-analysis

Abstract Background Recently, a nickel–titanium (NiTi) memory-shape device has been successfully used in gastrointestinal anastomosis. The aim of this study was to investigate the feasibility and safety of the device. Methods Four databases, reference lists, and the World Health Organization Interna...

Full description

Saved in:

Bibliographic Details
Published in:	The Journal of surgical research 2016-03, Vol.201 (1), p.82-93
Main Authors:	Li, Ning-Ning, MD, Zhao, Wen-Tao, MD, Wu, Xiao-Ting, MD
Format:	Article
Language:	eng
Subjects:	Anastomosis Anastomosis, Surgical - instrumentation CAC CAR Digestive System Surgical Procedures - instrumentation Eating Flatulence Gastrointestinal Tract - surgery Humans Length of Stay Meta-analysis Nickel Nickel–titanium compression anastomosis clip/ring Postoperative Complications Stapler Surgery Surgical Staplers Systematic review Titanium Treatment Outcome
Online Access:	Get full text
Tags:	Add Tag No Tags, Be the first to tag this record!

Description
Summary:	Abstract Background Recently, a nickel–titanium (NiTi) memory-shape device has been successfully used in gastrointestinal anastomosis. The aim of this study was to investigate the feasibility and safety of the device. Methods Four databases, reference lists, and the World Health Organization International Clinical Trials Registry Platform were systematically searched for randomized controlled trials assessing the clinical efficacy of a NiTi memory-shape device compared with that of a stapler in gastrointestinal or colorectal anastomosis. Results Seven randomized controlled trials regarding the use of compression anastomosis clips (CACs) were enrolled for meta-analysis. The use of CACs was associated with a significant reduction in hospital duration (mean = −0.88 d; 95% confidence interval [CI], −1.38 to −0.38), the time to flatus (mean = −0.36 d; 95% CI, −0.08 to −0.04), and the start of oral intake (mean = −0.45 d; 95% CI, −0.83 to −0.06), as well as a nonsignificant change in postoperative complications and mortality. These clinical outcomes did not significantly change with the use of compression anastomosis rings. Conclusions Colonic anastomosis with a CAC is likely to reduce hospital duration, time to flatus, and the start of oral intake without influencing mortality or postoperative complications and may be a safe and preferable choice in colonic anastomosis. Further well-designed trials should be performed to determine the safety and efficacy of the newly developed compression anastomosis ring in both ileocolic and colorectal anastomosis.
ISSN:	0022-4804 1095-8673