Staplers or clips?

Medicine (United States) - Tập 97 Số 45 - Trang e13116 - 2018
Yu Liu1,2, Zhongli Huang1,2, Yahong Chen1,2, Banghua Liao1,2, Liao Peng1,2, Xiaoshuai Gao1,2, Kunjie Wang1,2,3, Hong Li1,2,3
1Department of Urology, Institute of Urology (Laboratory of Reconstructive Urology), West China Hospital, Sichuan University, Chengdu, China
2Ethical approval: The meta-analysis was based on published retrospective studies. So, for this type of study ethical approval and formal consent are not required.
3Hong Li, Department of Urology, Institute of Urology (Laboratory of Reconstructive Urology), West China Hospital, Sichuan University, Chengdu 610041, China (e-mail: [email protected]).

Tóm tắt

Abstract Background: Controlling of the renal vessels is a critical step in live donor nephrectomy (LDN). Currently, mainly 2 devices, Hem-o-Lok clips and staplers, are utilized to control vessels during LDN. Both of them have advantages and disadvantages. Methods: This systematic review and meta-analysis was aimed to compare the safety and the efficacy of the 2 devices and to identify the better one in LDN. A systematic search for related publications in the databases of PubMed, Medline, Embase, the Cochrane Library, and Web of Science through February 2018 was performed. Eight studies were selected and evaluated with the Newcastle-Ottawa Scale (NOS). Results: The meta-analysis result showed that utilization of Hem-o-Lok clips resulted in greater amount of estimated blood loss (mean differences [MD]: 40.10; 95% confidence interval [CI] 4.37–75.84) and longer time of warm ischemia (WIT) (MD: 55.61; 95% CI 36.79–74.43) than using staplers. Residual vascular length of grafts in clip group was longer than that in stapler group (MD: 2.51; 95% CI 0.78–4.24). However, the differences in primary outcomes such as device failure rate, death rate, and severe hemorrhage rate, were not significant between these 2 groups. In addition, utilization of Hem-o-Lok clips costed approximate $400 lower than staplers per patient. Conclusion: This study revealed that Hem-o-Lok clips and staplers have the similar function in LDN renal ligation, regarding the device failure rate, death rate, and severe hemorrhage rate. However, the surgeons would benefit from the clips in terms of the residue length of vessels, these outstanding features provide operation convenience and flexibility, such as right-sided donor nephrectomies, early vascular bifurcation, and rare vascular variation. In addition, the clips have potential economic advantages. In some developing countries, it would reduce the healthcare expenditure.

Từ khóa


Tài liệu tham khảo

Clayman, 1991, Laparoscopic nephroureterectomy: initial clinical case report, J Laparoendosc Surg, 1, 343, 10.1089/lps.1991.1.343

Ratner, 1995, Laparoscopic live donor nephrectomy, Transplantation, 60, 1047

Devra, 2010, Laparoscopic right donor nephrectomy: endo TA stapler is safe and effective, Saudi J Kidney Dis Transpl, 21, 421

Ko, 2008, Utility of the endovascular stapler for right-sided laparoscopic donor nephrectomy: a 7-year experience at Mayo Clinic, J Am Coll Surg, 207, 896, 10.1016/j.jamcollsurg.2008.07.013

Chan, 2000, Endovascular gastrointestinal stapler device malfunction during laparoscopic nephrectomy: early recognition and management, J Urol, 164, 319, 10.1016/S0022-5347(05)67349-1

Kwazneski, 2013, The unacknowledged incidence of laparoscopic stapler malfunction, Surg Endosc, 27, 86, 10.1007/s00464-012-2417-y

Breda, 2007, Complications of laparoscopic living donor nephrectomy and their management: the UCLA experience, Urology, 69, 49, 10.1016/j.urology.2006.09.030

Deng, 2002, Laparoscopic linear cutting stapler failure, Urology, 60, 415, 10.1016/S0090-4295(02)01778-8

Liu, 2008, Techniques of vascular control in laparoscopic donor nephrectomy, Transplant Proc, 40, 2342, 10.1016/j.transproceed.2008.06.016

Jellison, 2008, Vessel length following laparoscopic donor nephrectomy: impact of vascular ligation technique on allograft vessel length, J Endourol, 22, 973, 10.1089/end.2007.0239

Friedman, 2006, F at al and nonfatal hemorrhagic complications of living kidney donation, Ann Surg, 243, 126, 10.1097/01.sla.0000193841.43474.ec

Janki, 2015, Vascular management during live donor nephrectomy: an online survey among transplant surgeons, Am J Transplant, 15, 1701, 10.1111/ajt.13142

Dekel, 2008, Hem-o-lok clip dislodgment causing death of the donor after laparoscopic living donor nephrectomy, Transplantation, 86, 887, 10.1097/TP.0b013e31818620b1

Meng, 2006, Reported failures of the polymer self-locking (Hem-o-lok) clip: review of data from the Food and Drug Administration, J Endourol, 20, 1054, 10.1089/end.2006.20.1054

Hsi, 2009, Analysis of techniques to secure the renal hilum during laparoscopic donor nephrectomy: review of the FDA database, Urology, 74, 142, 10.1016/j.urology.2008.11.010

Bittner, 2009, Comparison of renal artery occlusion techniques in hand-assisted laparoscopic living donor nephrectomy, J Endourol, 23, 933, 10.1089/end.2008.0297

Chueh, 2004, Use of Hem-o-lok clips effectively lengthens renal vein during laparoscopic live donor nephrectomy, Transplant Proc, 36, 2623, 10.1016/j.transproceed.2004.09.073

Goh, 2014, A necessary step toward kidney donor safety: the transition from locking polymer clips to transfixion techniques in laparoscopic donor nephrectomy, Transplant Proc, 46, 310, 10.1016/j.transproceed.2013.11.120

Kaushik, 2006, Comparison of techniques of vascular control in laparoscopic donor nephrectomy: the leicester experience, Transplant Proc, 38, 3406, 10.1016/j.transproceed.2006.10.142

Izaki, 2006, Clinical research of renal vein control using Hem-o-lok clips in laparoscopic nephrectomy, Int J Urol, 13, 1147, 10.1111/j.1442-2042.2006.01493.x

Siqueira, 2006, A cost-effective technique for pure laparoscopic live donor nephrectomy, Int Braz J Urol, 32, 23, 10.1590/S1677-55382006000100004

Chiu, 2003, Novel intracorporeal vascular knot applier for large vessel ligation in laparoscopic surgery: experience in pigs and preliminary clinical use, J Endourol, 17, 73, 10.1089/08927790360587379

Chon, 2005, Looped silk tie: surgical technique for management of the renal vein during laparoscopic live-donor nephrectomy, J Endourol, 19, 401, 10.1089/end.2005.19.401

Heniford, 2001, Initial results with an electrothermal bipolar vessel sealer, Surg Endosc, 15, 799, 10.1007/s004640080025

Sengupta, 2001, Use of a computer-controlled bipolar diathermy system in radical prostatectomies and other open urological surgery, ANZ J Surg, 71, 538, 10.1046/j.1440-1622.2001.02186.x

Constant, 2004, Use of the LigaSure vessel sealing device in laparoscopic living-donor nephrectomy, Transplantation, 78, 1661, 10.1097/01.TP.0000144379.29943.ED

Landman, 2003, Evaluation of a vessel sealing system, bipolar electrosurgery, harmonic scalpel, titanium clips, endoscopic gastrointestinal anastomosis vascular staples and sutures for arterial and venous ligation in a porcine model, J Urol, 169, 697, 10.1016/S0022-5347(05)63995-X

Helal, 1997, Laparoscopic nephrectomy using the harmonic scalpel, J Endourol, 11, 267, 10.1089/end.1997.11.267

Siperstein, 2002, The use of the harmonic scalpel vs conventional knot tying for vessel ligation in thyroid surgery, Arch Surg, 137, 137, 10.1001/archsurg.137.2.137

Kennedy, 1998, High-burst-strength, feedback-controlled bipolar vessel sealing, Surg Endosc, 12, 876, 10.1007/s004649900733

Sundaram, 2006, Methods of vascular control during laparoscopic donor nephrectomy, J Endourol, 20, 467, 10.1089/end.2006.20.467

Bernie, 2006, Laparoscopic vascular control techniques in donor nephrectomy: effects on vessel length, JSLS, 10, 141

Meng, 2003, Techniques to optimize vascular control during laparoscopic donor nephrectomy, Urology, 61, 93, 10.1016/S0090-4295(02)02133-7

Baek, 2004, Open conversion from laparoscopic nephrectomy: slippage of surgical clips ligating the renal artery affected by atherosclerosis, J Urol, 171, 333, 10.1097/01.ju.0000102478.32057.13

Maartense, 2003, Renal artery clip dislodgement during hand-assisted laparoscopic living donor nephrectomy, Surg Endosc, 17, 1851, 10.1007/s00464-003-4230-0

Chan, 2001, Rapid ligation of renal hilum during transperitoneal laparoscopic nephrectomy, Urology, 57, 360, 10.1016/S0090-4295(00)01078-5

Kumar, 2004, Laparoscopic live-donor nephrectomy: modifications for developing nations, BJU Int, 93, 1291, 10.1111/j.1464-410X.2004.04823.x

Sureka, 2016, Safe vascular control in laparoscopic donor nephrectomy: an experience of more than 1400 cases, Ind J Transplant, 10, 111, 10.1016/j.ijt.2016.09.078

Chibber, 2006, Are titanium clips for control of the renal hilar vessels as unsafe as generally presumed?, Surg Laparosc Endosc Percutan Tech, 16, 276, 10.1097/00129689-200608000-00019

Jellison, 2005, Comparison of nonabsorbable polymer ligating and standard titanium clips with and without a vascular cuff, J Endourol, 19, 889, 10.1089/end.2005.19.889

Abreu, 2004, Factors related to delayed graft function after laparoscopic live donor nephrectomy, J Urol, 171, 52, 10.1097/01.ju.0000098819.79442.ce

Van der Merwe, 2014, Retroperitoneoscopic live donor nephrectomy: review of the first 50 cases at Tygerberg Hospital, Cape Town, South Africa, S Afr J Surg, 52, 53, 10.7196/sajs.2080

Simforoosh, 2006, Effect of warm ischemia on graft outcome in laparoscopic donor nephrectomy, J Endourol, 20, 895, 10.1089/end.2006.20.895

Kerbl, 1993, Ligation of the renal pedicle during laparoscopic nephrectomy: a comparison of staples, clips, and sutures, J Laparoendosc Surg, 3, 9, 10.1089/lps.1993.3.9

Schatloff, 2009, Is postoperative arteriovenous fistula still a concern after en bloc stapling of the renal hilum during laparoscopic nephrectomy?, J Endourol, 23, 639, 10.1089/end.2008.0528

Resorlu, 2015, Comparative analysis of pedicular vascular control techniques during laparoscopic nephrectomy: en bloc stapling or separate ligation?, Urol Int, 94, 79, 10.1159/000363250

Hemal, 2010, Retroperitoneoscopic nephrectomy for pyonephrotic nonfunctioning kidney, Urology, 75, 585, 10.1016/j.urology.2008.07.054

Elliott, 2005, Bursting strength with various methods of renal artery ligation and potential mechanisms of failure, J Endourol, 19, 307, 10.1089/end.2005.19.307

Papaioannou, 1996, Safety evaluation of laparoscopically applied clips, J Laparoendosc Surg, 6, 99, 10.1089/lps.1996.6.99

Joseph, 2004, Comparison of the Ti-knot device and Hem-o-lok clips with other devices commonly used for laparoscopic renal-artery ligation, J Endourol, 18, 163, 10.1089/089277904322959806

McGregor, 2017, Vascular control during laparoscopic kidney donation, Can J Surg, 60, 150, 10.1503/cjs.016016

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Medicine (United States)

Tập 97 Số 45

e13116

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