Single- versus two- layer intestinal anastomosis: A meta-analysis of randomized controlled trials

被引：39
作者：
Shikata S. [1 ,2 ]
Yamagishi H. [1 ]
Taji Y. [2 ]
Shimada T. [3 ]
Noguchi Y. [3 ]
机构：
[1] Department of Digestive Surgery, Kyoto Prefectural University of Medicine, Kyoto
[2] Department of Clinical Epidemiology, Kyoto University, Kyoto
[3] Department of Medicine, Fujita Health University, School of Medicine, Aichi
来源：
BMC Surgery | / 6卷 / 1期
关键词：
Total Parenteral Nutrition; Suture Technique; Intestinal Resection; Intestinal Anastomosis; Jadad Score;
D O I：
10.1186/1471-2482-6-2
中图分类号：
学科分类号：
摘要：
Background: To compare single- with two- layer intestinal anastomosis after intestinal resection: a meta-analysis of randomized controlled trials. Methods: Randomized controlled trials comparing single- with two-layer intestinal anastomosis were identified using a systematic search of Medline, Embase and the Cochrane Library Databases covering articles published from 1966 to 2004. Outcome of primary interest was postoperative leak. A risk ratio for trial outcomes and weighted pooled estimates for data were calculated. A fixed-effect model weighted using Mantel-Haenszel methods and a random-effect model using DerSimonian-Laird methods were employed. Results: Six trials were analyzed, comprising 670 participants (single-layer group, n = 299; two-layer group, n = 371). Data on leaks were available from all included studies. Combined risk ratio using DerSimonian-Laird methods was 0.91 (95% CI = 0.49 to 1.69), and indicated no significant difference. Inter-study heterogeneity was significant (χ2 = 10.5, d.f. = 5, p = 0.06). Conclusion: No evidence was found that two-layer intestinal anastomosis leads to fewer postoperative leaks than single layer. Considering duration of the anastomosis procedure and medical expenses, single-layer intestinal anastomosis appears to represent the optimal choice for most surgical situations. © 2006 Shikata et al; licensee BioMed Central Ltd.
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页数：7
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