Nickel-titanium memory-shape compression anastomosis clip for gastrointestinal anastomosis:a Meta-analysis and sequential analysis

doi:10.3969/j.issn.2095-4344.2017.18.025

Abstract

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 controlled trials about Ni-Ti CAC versus 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 enrolled, involving 1 860 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; additionally, 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.

中国组织工程研究杂志出版内容重点：生物材料；骨生物材料; 口腔生物材料; 纳米材料; 缓释材料; 材料相容性；组织工程

Key words: Tissue Engineering, Alloys, Nickel, Titanium, Anastomosis, Surgical

CLC Number:

R318

Wu Jian-yu, Sun Wei-peng, Guo Wei, Yang Hai-gan, Zhang Zi-jing, Hou Zheng-kun, Fan Dong-mei, Wen Jun-mao, Chen Yu-zhong. Nickel-titanium memory-shape compression anastomosis clip for gastrointestinal anastomosis:a Meta-analysis and sequential analysis[J]. Chinese Journal of Tissue Engineering Research, 2017, 21(18): 2946-2952.

Figures/Tables 9

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