title: Assessing the Impact of Barbed Suture on Vesicourethral Anastomosis During Minimally Invasive Radical Prostatectomy: A Systematic Review and Meta-analysis.
abstract: OBJECTIVE
  To examine the effectiveness of barbed suture (BS) compared with conventional sutures for vesicourethral anastomosis (VUA) during minimally invasive radical prostatectomy (RP).
  
  
  METHODS
  Relevant studies comparing the safety and efficacy of BS with conventional sutures during minimally invasive RP were identified through a literature search using MEDLINE, EMBASE, and the Cochrane Library. The outcome measures included baseline characteristics, primary outcomes, and secondary outcomes.
  
  
  RESULTS
  Ten studies (378 cases and 369 controls) were included. No significant differences between the 2 groups were detected in any of the baseline variables except for age (P = .02). The BS group had a shorter operation time (mean difference [MD], 10.54; 95% confidence interval [CI], -14.38 to -6.69; P <.01), a shorter VUA time (MD, -5.35; 95% CI, -7.44 to -3.25; P <.01), and a shorter posterior reconstruction time (MD, -0.56; 95% CI, -1.10 to -0.02; P = .04) than those in the conventional sutures group. No significant differences were detected between the 2 groups in other outcomes of interest. In subgroup and sensitivity analyses, there was no change in the significance of any of the outcomes.
  
  
  CONCLUSIONS
  This meta-analysis indicates that VUA using BS as opposed to conventional suture is associated with a shorter operative time, comparable postoperative complication rate, and convenience for manipulation, which is of benefit to the surgeon learning robot-assisted RP and laparoscopic RP. Given that the inherent limitations, future well-designed randomized controlled trials are required to confirm our findings.
authors: Department of Urology, West China Hospital, Sichuan University, Chengdu, China.
authors: Yunjin
authors: Y
authors: Bai
authors: Department of Urology, West China Hospital, Sichuan University, Chengdu, China.
authors: Chunxiao
authors: C
authors: Pu
authors: Department of Urology, West China Hospital, Sichuan University, Chengdu, China.
authors: Haichao
authors: H
authors: Yuan
authors: Department of Urology, West China Hospital, Sichuan University, Chengdu, China.
authors: Yin
authors: Y
authors: Tang
authors: Department of Urology, West China Hospital, Sichuan University, Chengdu, China.
authors: Xiaoming
authors: X
authors: Wang
authors: Department of Urology, West China Hospital, Sichuan University, Chengdu, China.
authors: Jinhong
authors: J
authors: Li
authors: Department of Urology, West China Hospital, Sichuan University, Chengdu, China.
authors: Qiang
authors: Q
authors: Wei
authors: Department of Urology, West China Hospital, Sichuan University, Chengdu, China. Electronic address: hanpingwch@163.com.
authors: Ping
authors: P
authors: Han
mesh_terms: D000714:Anastomosis, Surgical; D006801:Humans; D008297:Male; D019060:Minimally Invasive Surgical Procedures; D011468:Prostatectomy / Q000379:methods*; D013536:Suture Techniques; D014521:Urethra / Q000601:surgery*; D001743:Urinary Bladder / Q000601:surgery*