Ban B, Shang A, Shi J. Efficacy of staple line reinforcement by barbed suture for preventing anastomotic leakage in laparoscopic rectal cancer surgery. World J Gastrointest Surg 2022; 14(8): 821-832 [PMID: 36157360 DOI: 10.4240/wjgs.v14.i8.821]
Corresponding Author of This Article
Jian Shi, MD, PhD, Associate Chief Physician, Associate Professor, Department of General Surgery, The Second Hospital of Jilin University, No. 218 Ziqiang Street, Nanguan District, Changchun 130041, Jilin Province, China. 383888697@qq.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Surg. Aug 27, 2022; 14(8): 821-832 Published online Aug 27, 2022. doi: 10.4240/wjgs.v14.i8.821
Efficacy of staple line reinforcement by barbed suture for preventing anastomotic leakage in laparoscopic rectal cancer surgery
Bo Ban, An Shang, Jian Shi
Bo Ban, An Shang, Jian Shi, Department of General Surgery, The Second Hospital of Jilin University, Changchun 130041, Jilin Province, China
Author contributions: Ban B designed the research and wrote the manuscript; Shi J designed the research and supervised the manuscript; Shang A performed the research and contributed to the statistical analysis.
Supported byScience and Technology Development Project of Jilin Province, China, No. 2020SCZT079.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of The Second Hospital of Jilin University.
Informed consent statement: All study participants or their legal guardian provided informed written consent about personal and medical data collection prior to study enrolment.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jian Shi, MD, PhD, Associate Chief Physician, Associate Professor, Department of General Surgery, The Second Hospital of Jilin University, No. 218 Ziqiang Street, Nanguan District, Changchun 130041, Jilin Province, China. 383888697@qq.com
Received: April 22, 2022 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
ARTICLE HIGHLIGHTS
Research background
Anastomotic leakage (AL) is a severe complication in rectal cancer surgery. Various methods have been used to reduce the incidence of AL.
Research motivation
We hypothesized that staple-line reinforcement using barbed suture could reduce the incidence of AL in laparoscopic surgery for rectal cancer.
Research objectives
To evaluate the efficacy of staple-line reinforcement using barbed suture for preventing AL in laparoscopic surgery for rectal cancer.
Research methods
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.
Research results
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.
Research conclusions
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.
Research perspectives
A large-scale prospective randomized controlled trial is needed for evaluating the efficacy of staple-line reinforcement for preventing AL.
