A Meta-analysis of Powered Circular Stapler Versus Manual Circular Stapler for Colorectal Anastomosis.

IF 1.8 4区医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL

In vivo Pub Date : 2025-07-01 DOI:10.21873/invivo.14012

Hiroshi Ohtani, Masatsune Shibutani, Fukuoka Tatsunari, Hiroaki Kasashima, Kiyoshi Maeda

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引用次数: 0

Abstract

Background/aim: The anastomotic leakage rate of the double stapling technique anastomosis in colorectal surgery remains high at approximately 10%. The Echelon Circular™ powered stapler (ECPS) has been recently reported to reduce the risk of anastomotic leakage. A meta-analysis was conducted to evaluate and compare the effectiveness of ECPS to that of the manual circular stapler (MCS) in left-sided colorectal resections.

Materials and methods: We searched publicly available literature databases for studies published between 2018 and August 2024. The following search terms were used: "powered circular stapler", "powered circular", "anastomosis", and "powered echelon". We analyzed several outcomes including anastomotic leakage, major anastomotic leakage, and anastomotic bleeding. A subgroup analysis was performed to analyze Japanese cases only.

Results: We identified 9 papers reporting results that compared ECPS for left-sided colorectal resection with MCS. Our meta-analysis included 3,301 patients with colorectal anastomosis; 1,135 had undergone ECPS and 2,166 had undergone MCS. The overall anastomotic leakage rate was significantly lower in the ECPS group than in the MCS group (p<0.0001). Regarding major anastomotic leakage, there was a tendency for the ECPS group to include fewer cases than the MCS group (p=0.10). For anastomotic bleeding, no significant difference was found between the two groups. In the subgroup analysis of Japanese patients, ECPS also showed significantly lesser anastomotic leakage than MCS.

Conclusion: ECPS may significantly reduce the rate of anastomotic leakage in left-sided colorectal surgery compared to MCS in both the Western and Asian populations.

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动力圆形吻合器与手动圆形吻合器在结直肠吻合术中的meta分析。

背景/目的：双吻合器吻合术在结直肠手术中吻合口漏率居高不下，约为10%。最近有报道称，Echelon Circular™动力吻合器（ECPS）可降低吻合口瘘的风险。进行了一项荟萃分析，以评估和比较ECPS与手动圆形吻合器（MCS）在左侧结肠直肠切除术中的有效性。材料和方法：我们检索了2018年至2024年8月期间发表的公开文献数据库。使用了以下搜索词：“动力圆形订书机”、“动力圆形”、“吻合”和“动力梯队”。我们分析了几种结果，包括吻合口瘘、吻合口大瘘和吻合口出血。对日本病例进行亚组分析。结果：我们确定了9篇报道左侧结肠直肠癌ECPS与MCS的比较结果的论文。我们的荟萃分析包括3301例结直肠吻合术患者；1135例接受ECPS， 2166例接受MCS。ECPS组吻合口漏总发生率明显低于MCS组（pp=0.10）。两组吻合口出血发生率无明显差异。在日本患者的亚组分析中，ECPS的吻合口漏也明显少于MCS。结论：在西方和亚洲人群中，与MCS相比，ECPS可显著降低左侧结直肠手术吻合口漏的发生率。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

In vivo 医学-医学：研究与实验

CiteScore

4.20

自引率

4.30%

发文量

330

审稿时长

3-8 weeks

期刊介绍： IN VIVO is an international peer-reviewed journal designed to bring together original high quality works and reviews on experimental and clinical biomedical research within the frames of physiology, pathology and disease management. The topics of IN VIVO include: 1. Experimental development and application of new diagnostic and therapeutic procedures; 2. Pharmacological and toxicological evaluation of new drugs, drug combinations and drug delivery systems; 3. Clinical trials; 4. Development and characterization of models of biomedical research; 5. Cancer diagnosis and treatment; 6. Immunotherapy and vaccines; 7. Radiotherapy, Imaging; 8. Tissue engineering, Regenerative medicine; 9. Carcinogenesis.