title: Can a nickel-titanium memory-shape device serve as a substitute for the stapler in gastrointestinal anastomosis? A systematic review and meta-analysis.
abstract: BACKGROUND
  Recently, a nickel-titanium (NiTi) memory-shape device has been successfully used in gastrointestinal anastomosis. The aim of this study was to investigate the feasibility and safety of the device.
  
  
  METHODS
  Four databases, reference lists, and the World Health Organization International Clinical Trials Registry Platform were systematically searched for randomized controlled trials assessing the clinical efficacy of a NiTi memory-shape device compared with that of a stapler in gastrointestinal or colorectal anastomosis.
  
  
  RESULTS
  Seven randomized controlled trials regarding the use of compression anastomosis clips (CACs) were enrolled for meta-analysis. The use of CACs was associated with a significant reduction in hospital duration (mean = -0.88 d; 95% confidence interval [CI], -1.38 to -0.38), the time to flatus (mean = -0.36 d; 95% CI, -0.08 to -0.04), and the start of oral intake (mean = -0.45 d; 95% CI, -0.83 to -0.06), as well as a nonsignificant change in postoperative complications and mortality. These clinical outcomes did not significantly change with the use of compression anastomosis rings.
  
  
  CONCLUSIONS
  Colonic anastomosis with a CAC is likely to reduce hospital duration, time to flatus, and the start of oral intake without influencing mortality or postoperative complications and may be a safe and preferable choice in colonic anastomosis. Further well-designed trials should be performed to determine the safety and efficacy of the newly developed compression anastomosis ring in both ileocolic and colorectal anastomosis.
authors: Department of General Surgery, The Third Affiliated Hospital, Guangzhou Medical University, Guangzhou, China.
authors: Ning-Ning
authors: NN
authors: Li
authors: Department of Colorectal Surgery, The First Affiliated Hospital, Guangzhou University of Traditional Chinese Medicine, Guangzhou, China. Electronic address: zhao_wen_tao@yeah.net.
authors: Wen-Tao
authors: WT
authors: Zhao
authors: Department of General Surgery, West China Hospital, Sichuan University, Chengdu, China.
authors: Xiao-Ting
authors: XT
authors: Wu
mesh_terms: D000714:Anastomosis, Surgical / Q000295:instrumentation*; D013505:Digestive System Surgical Procedures / Q000295:instrumentation*; D004435:Eating; D005414:Flatulence; D041981:Gastrointestinal Tract / Q000601:surgery*; D006801:Humans; D007902:Length of Stay; D009532:Nickel; D011183:Postoperative Complications; D013528:Surgical Staplers; D014025:Titanium; D016896:Treatment Outcome
chemical_list: C040654:titanium nickelide; D009532:Nickel; D014025:Titanium
keywords: Anastomosis; CAC; CAR; Meta-analysis; Nickel–titanium compression anastomosis clip/ring; Stapler; Systematic review