Double Stapling Technique Versus Single Stapling Technique In Anterior Resection For Rectal Cancer:a Meta-analysis

Objective To evaluate the clinical effectiveness of Double Stapling Techniques (DST) and Single Stapling Techniques (SST) for the treatment of rectal cancer.Methods We did a systematic literature search for articles from MEDLINE, EMbase, Cochrane Library, CBMdisc, Chinese VIP Database, CNKI, and WANFANG Database on internet. Publications were included if they were randomized controlled trials (RCTs) in which patients underwent either DST or SST. The search time was from establishment of each database to March,2014. Data were extracted and evaluated by two reviewers independently. The quality of the included trials was evaluated. All the randomized controlled trials were included for Meta-analysis with the RevMan5.2software.Results Five randomized controlled trials(342patients) were included. The results of meta-analysis showed that:DST group was superior in the following aspects with singnificant differences:Operation time [WMD=13.20,95%CI (18.98,7.42), P<0.01], Incomplete cut rings Rate [OR=0.30,95%CI (0.10,0.10), P<0.05], Anastomotic Leakage Rate [OR=0.37,95%CI (0.17,0.17), P=0.01]. Radiologic leaks Rate [OR=0.27,95%CI (0.07,0.07), P=0.05]. The anastomotic stenosis incidence of DST group is more than SST group, but there was no statistically significant difference [OR=3.15,95%CI (0.32,0.32), P>0.05].Conclusion DST is a safe procedure for the treatment of rectal cancer. DST is superior to SST in operation time, Incomplete cut rings Rate, Anastomotic Leakage Rate, Radiologic leaks Rate. The anastomotic stenosis incidence of DST group is more than SST group, but there was no statistically significant difference. DST is better than SST in anterior resection for rectal cancer.