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- Title
Current evidence on powered versus manual circular staplers in colorectal surgery: a systematic review and meta-analysis.
- Authors
Martín-Arévalo, José; Moro-Valdezate, David; Pérez-Santiago, Leticia; López-Mozos, Fernando; Peña, Carlos Javier; Carbonell Asins, Juan Antonio; Casado Rodrigo, David; García-Botello, Stephanie; Gil-Alfosea, Claudia; Pla-Martí, Vicente
- Abstract
Purpose: This meta-analysis aims to evaluate the efficacy of powered circular staplers (PCS) compared to manual circular staplers (MCS) in reducing anastomotic leakage (AL) and postoperative bleeding (AB) in colorectal surgery. Methods: Extensive searches were performed in the Embase, PubMed, and SCOPUS electronic bibliographic databases. Most studies were of an observational nature, and only one randomized clinical trial was identified. Results: Twelve studies met the inclusion criteria for anastomotic leakage and five for anastomotic hemorrhage. The number of patients included for AL analysis was 4524. The leakage rate was 4.6% (208 cases). The number of patients with AB was 2868 with a bleeding rate of 4.99% (143 patients). After identifying outliers and studies with possible selection bias, the odds ratio (OR) for leaks and PCS was 0.38 (95% CI 0.26–0.55), the relative risk was − 0.05 (95% CI − 0.07 to 0.03), and the number needed to treat to prevent one leak was 20. For bleeding, the PCS OR for PCS was 0.20 (95% CI 0.0772–0.5177). Conclusion: Powered circular staplers could be associated with a significantly lower risk of leakage and anastomotic bleeding than two-row manual circular staplers. Further prospective randomized trials are needed to validate these findings.
- Subjects
BIBLIOGRAPHIC databases; PROCTOLOGY; SURGICAL complications; ODDS ratio; CLINICAL trials; STAPLERS (Surgery)
- Publication
International Journal of Colorectal Disease, 2025, Vol 40, Issue 1, p1
- ISSN
0179-1958
- Publication type
Academic Journal
- DOI
10.1007/s00384-025-04807-y