Published online Aug 27, 2022. doi: 10.4240/wjgs.v14.i8.821
Peer-review started: April 22, 2022
First decision: June 19, 2022
Revised: June 28, 2022
Accepted: July 26, 2022
Article in press: July 26, 2022
Published online: August 27, 2022
Processing time: 124 Days and 3.7 Hours
Anastomotic leakage (AL) is a severe complication in rectal cancer surgery. Various methods have been used to reduce the incidence of AL.
We hypothesized that staple-line reinforcement using barbed suture could reduce the incidence of AL in laparoscopic surgery for rectal cancer.
To evaluate the efficacy of staple-line reinforcement using barbed suture for preventing AL in laparoscopic surgery for rectal cancer.
We compared the incidence of AL and other operative complications between two groups and analyzed patient-, tumor-, as well as surgery-related variables using univariate and multivariate logistic analyses.
AL incidence was significantly lower in the reinforcing suture group than in the control group (4.8% vs 11.3%, P = 0.031). The multivariate analyses demonstrated that the tumor site, tumor size and presence of staple-line reinforcement were independent risk factors for AL. In patients with risk factors, the AL incidence considerably decreased in the experimental group compared with that in the control group (P = 0.038). However, for patients without risk factor, no significant difference was found between experimental group and control group.
Staple-line reinforcement can significantly lower AL incidence for patients with risk factors, while reducing AL severity and decreasing the reoperation rate. Besides, this technique does not increase the occurrence of postoperative complications.
A large-scale prospective randomized controlled trial is needed for evaluating the efficacy of staple-line reinforcement for preventing AL.