Benefits of barbed suture utilisation in gastrointestinal anastomosis: a systematic review and meta-analysis.

INTRODUCTION: Anastomosis formation constitutes a critical aspect of many gastrointestinal procedures. Barbed suture materials have been adopted by some surgeons to assist in this task. This systematic review and meta-analysis compares the safety and efficacy of barbed suture material for anastomosis formation compared with standard suture materials.

METHODS: An electronic search of Embase, Medline, Web of Science and Cochrane databases was performed. Weighted mean differences were calculated for effect size of barbed suture material compared with standard material on continuous variables and pooled odds ratios were calculated for discrete variables.

FINDINGS: There were nine studies included. Barbed suture material was associated with a significant reduction in overall operative time (WMD: -12.87 (95% CI = -20.16 to -5.58) ( P = 0.0005)) and anastomosis time (WMD: -4.28 (95% CI = -6.80 to -1.75) ( P = 0.0009)). There was no difference in rates of anastomotic leak (POR: 1.24 (95% CI = 0.89 to 1.71) ( P = 0.19)), anastomotic bleeding (POR: 0.80 (95% CI = 0.29 to 2.16) ( P = 0.41)), or anastomotic stricture (POR: 0.72 (95% CI = 0.21 to 2.41) ( P = 0.59)).

CONCLUSIONS: Use of barbed sutures for gastrointestinal anastomosis appears to be associated with shorter overall operative times. There was no difference in rates of complications (including anastomotic leak, bleeding or stricture) compared with standard suture materials.