The efficacy and safety of using a bipolar sealer to prevent blood loss in spine surgery: A meta-analysis.
Int J Surg
; 46: 37-46, 2017 Oct.
Article
en En
| MEDLINE
| ID: mdl-28797919
ABSTRACT
OBJECTIVE:
The purpose of this systematic review and meta-analysis of randomized controlled trials (RCTs) and non-RCTs was to evaluate the effect of using a bipolar sealer to prevent surgical bleeding in spine surgery.METHODS:
In June 2017, the PubMed, Embase, Cochrane controlled trials register, Web of Science, Google, and Chinese Wanfang databases were used to identify RCTs and non-RCTs comparing the effects of intraoperative placement of a bipolar sealer versus standard electrocautery with regard to blood loss and blood transfusion. Stata 12.0 software was used to perform the meta-analysis. Weighted mean differences with 95% confidential intervals (CIs) were used for continuous outcomes, and relative risks with 95% CIs were used for discontinuous outcomes. After testing for publication bias and heterogeneity across studies, the data were aggregated and assessed with a random effects model when necessary.RESULTS:
In total, 6 clinical trials with 560 patients were included in this meta-analysis. The pooled results indicated that the use of a bipolar sealer decreased the estimated blood loss (MD = -165.06, 95% CI -236.73 to -93.40, P < 0.001), the need for a blood transfusion (RR = 0.46, 95% CI 0.31 to 0.68, P < 0.001), the transfusion units used (MD = -0.41, 95% CI -0.60 to -0.21, P < 0.001), the operative time (MD = -12.98, 95% CI -21.82 to -4.15, P = 0.004) and the length of hospital stay (MD = -2.77, 95% CI -5.45 to -0.10, P = 0.042). No significant difference was observed for the occurrence of infection (RR = 0.52, 95% CI 0.19 to 1.39, P = 0.192).CONCLUSION:
Based on the current meta-analysis, the use of a bipolar sealer is superior to standard electrocautery for reducing intraoperative blood loss and is therefore recommend for use during spine surgery.Palabras clave
Texto completo:
1
Ejes tematicos:
Pesquisa_clinica
Banco de datos:
MEDLINE
Asunto principal:
Columna Vertebral
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Pérdida de Sangre Quirúrgica
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Electrocoagulación
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Terapia por Radiofrecuencia
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Hemostasis Quirúrgica
Tipo de estudio:
Clinical_trials
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Systematic_reviews
Límite:
Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Año:
2017
Tipo del documento:
Article