Retrospective Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
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 by Science 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
Processing time: 124 Days and 3.7 Hours
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.