How Does Oversewing/Suturing (OS/S) Compare to Other Staple Line Reinforcement Methods? A Systematic Review and Meta-Analysis

Obes Surg. 2024 Mar;34(3):985-996. doi: 10.1007/s11695-024-07069-9. Epub 2024 Jan 23.

Abstract

Various staple line reinforcement (SLR) techniques in sleeve gastrectomy, including oversewing/suturing (OS/S), gluing, and buttressing, have emerged to mitigate postoperative complications such as bleeding and leaks. A meta-analysis of randomized controlled trials has demonstrated OS/S as an efficacious strategy for preventing postoperative complications, encompassing leaks, bleeding, and reoperations. Given that OS/S is the sole SLR technique not incurring additional costs during surgery, our study aimed to compare postoperative outcomes associated with OS/S versus alternative SLR methods. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we reviewed the literature and conducted fifteen pairwise meta-analyses of comparative studies, each evaluating an outcome between OS/S and another SLR technique. Thirteen of these analyses showed no statistically significant differences, whereas two revealed notable distinctions.

Keywords: Buttressing; Glue; Oversewing; Sealant; Sleeve gastrectomy; Staple line reinforcement; Suturing.

Publication types

  • Systematic Review
  • Meta-Analysis
  • Comparative Study
  • Review

MeSH terms

  • Anastomotic Leak / epidemiology
  • Anastomotic Leak / prevention & control
  • Gastrectomy / methods
  • Humans
  • Obesity, Morbid / surgery
  • Postoperative Complications / epidemiology
  • Postoperative Complications / prevention & control
  • Randomized Controlled Trials as Topic
  • Reoperation / statistics & numerical data
  • Surgical Stapling* / methods
  • Suture Techniques
  • Treatment Outcome