Nickel-titanium memory-shape compression anastomosis clip for gastrointestinal anastomosis: a Meta-analysis and sequential analysis
10.3969/j.issn.2095-4344.2017.18.025
- VernacularTitle:镍钛记忆合金加压吻合夹在消化道吻合术中的系统评价及序贯分析
- Author:
Jianyu WU
;
Weipeng SUN
;
Wei GUO
;
Haigan YANG
;
Zijing ZHANG
;
Zhengkun HOU
;
Dongmei FAN
;
Junmao WEN
;
Yuzhong CHEN
- Keywords:
Tissue Engineering;
Alloys;
Nickel;
Titanium;
Anastomosis;
Surgical
- From:
Chinese Journal of Tissue Engineering Research
2017;21(18):2946-2952
- CountryChina
- Language:Chinese
-
Abstract:
BACKGROUND:Nickel-titanium memory-shape compression anastomosis clip (Ni-Ti CAC) has been used in gastrointestinal anastomosis, but its efficacy and safety still remain controversial.OBJECTIVE:To evaluate the efficacy and safety of Ni-Ti CAC in gastrointestinal anastomosis.METHODS:A computer-based online research of PubMed, EMbase, Cochrane Library, CBM, CNKI, and VIP databases was performed for articles published before January 15th, 2017 using the keywords of nickel-titanium, compression anastomosis clip, anastomosis, gastric, jejunum, ileum, small intestine, colon, rectum, and large intestine in English and Chinese, respectively. The randomized controled trials about Ni-Ti CACversus conventional methods for gastrointestinal anastomosis were included. Meta-analysis of the anastomosis time, time of exsufflation, and hospitalization time was performed, and sequential analysis was conducted on TSA v0.9 software.RESULTS AND CONCLUSION:A total of 18 eligible randomized controlled trials were enroled, involving 1860 patients. Ni-Ti CAC could reduce the anastomosis time [MD=-3.83, 95%CI(-6.48,-1.19),P=0.004] and time of exsufflation [MD=-0.14, 95%CI(-0.22,-0.05),P=0.002], but there was no significant difference in the hospitalization time [MD=-0.83, 95%CI(-1.82, 0.16), P=0.10]. The quality was ranked as low level based on GRADE system. The time of exsufflation of Ni-Ti CAC was superior to that of conventional method, which was confirmed by sequential analysis. One case of death was reported and incision infection was the most common adverse effects; additionaly, pulmonary embolism and abdominal pain occurred. To conclude, Ni-Ti CAC can facilitate gastrointestinal anastomosis, accelerate the time of exsufflation, and holds a good safety. However, more multicenter and high-quality randomized controlled trials are needed.
