Impact of a circular powered stapler on preventing anastomotic leakage in patients with left-sided colorectal cancer: a retrospective study

Shibutani, Masatsune; Fukuoka, Tatsunari; Iseki, Yasuhito; Kasashima, Hiroaki; Kitayama, Kishu; Maeda, Kiyoshi

doi:10.1186/s12893-023-02104-5

Cited by 4 publications

(1 citation statement)

References 25 publications

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“…The decrease in the incidence of anastomotic leakage reported by some publications on the experience of the new PCS [ 13 , 19 , 25 , 27 , 37 ] and TRCS [ 12 , 29 , 38 ] compared with the two-row circular staplers should be viewed with caution because they are observational studies, not randomized clinical trials. Furthermore, there is some heterogeneity in the studies because multicentre studies have been included, some of them with cases from large national databases or on-going clinical trials not designed to assess the difference in leakage rates among different devices [ 29 , 39 , 40 ].…”

Section: Discussionmentioning

confidence: 99%

Two-row, three-row or powered circular stapler, which to choose when performing colorectal anastomosis? A systematic review and meta-analysis

Martín-Arévalo,

Pla-Martí,

Huntley

et al. 2024

Int J Colorectal Dis

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Purpose Three types of circular staplers can be used to perform a colorectal anastomosis: two-row (MCS), three-row (TRCS) and powered (PCS) devices. The objective of this meta-analysis has been to provide the existing evidence on which of these circular staplers would have a lower risk of presenting a leak (AL) and/or anastomotic bleeding (AB). Methods An in-depth search was carried out in the electronic bibliographic databases Embase, PubMed and SCOPUS. Observational studies were included, since randomized clinical trials comparing circular staplers were not found. Results In the case of AL, seven studies met the inclusion criteria in the PCS group and four in the TRCS group. In the case of AB, only four studies could be included in the analysis in the PCS group. The AL OR reported for PCS was 0.402 (95%-confidence interval (95%-CI): 0.266–0.608) and for AB: 0.2 (95% CI: 0.08–0.52). The OR obtained for AL in TRCS was 0.446 (95%-CI: 0.217 to 0.916). Risk difference for AL in PCS was − 0.06 (95% CI: − 0.07 to − 0.04) and in TRCS was − 0.04 (95%-CI: − 0.08 to − 0.01). Subgroup analysis did not report significant differences between groups. On the other hand, the AB OR obtained for PCS was 0.2 (95% CI: 0.08–0.52). In this case, no significant differences were observed in subgroup analysis. Conclusion PCS presented a significantly lower risk of leakage and anastomotic bleeding while TRCS only demonstrated a risk reduction in AL. Risk difference of AL was superior in the PCS than in TRCS.

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