SynthesisLangenbeck's archives of surgery2015
Hand suture versus stapler for closure of loop ileostomy--a systematic review and meta-analysis of randomized controlled trials.
Synthesis in Langenbeck's archives of surgery, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05753709 (Conventional Hand Sewn End-To-End Anastomosis Versus Side-To-Side Anastomosis for Stoma Reversal), which is not on this map. Cited by 22 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Conventional Hand Sewn End-To-End Anastomosis Versus Side-To-Side Anastomosis for Stoma Reversal: A Randomised Clinical Trial
Who cites it
22 citing papers in PubMed, 1 synthesis or guideline pooled it, 54 citations in OpenAlex.
- Italian guidelines for the surgical management of enteral stomas in adults.Techniques in coloproctology · 2019Guideline
- The ILEOSTIM trial: A multicentre randomised controlled trial evaluating the impact of efferent loop stimulation prior to ileostomy reversal on postoperative ileus.Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland · 2026Trial
- Ileostomy reversal with handsewn techniques. Short-term outcomes in a teaching hospital.International journal of colorectal disease · 2017Trial
- Impact of anastomotic technique and norepinephrine on microcirculation in colorectal surgery: findings from a porcine model using laser speckle contrast imaging.Techniques in coloproctology · 2025Article
- Thirty-year compliance with a surveillance program for patients with familial adenomatous polyposis.Familial cancer · 2025Article
- IMMEDIATE AND LATE RESULTS OF ILEOSTOMY CLOSURE IN PATIENTS WITH FAMILIAL ADENOMATOUS POLYPOSIS UNDERGOING RESTORATIVE PROCTOCOLECTOMY BY OPEN OR LAPAROSCOPIC APPROACHES.Arquivos de gastroenterologia · 2025Article
- Current approach to loop ileostomy closure: a nationwide survey on behalf of the Italian Society of ColoRectal Surgery (SICCR).Updates in surgery · 2025Article
- Temporary diverting loop ileostomy in Crohn's disease surgery; indications and outcome.Langenbeck's archives of surgery · 2024Article
- Short-term outcome of diverting loop ileostomy reversals performed by residents: a retrospective cohort prognostic factor study.International journal of colorectal disease · 2023Article
- Feasibility and advantages analyses of wedge resection without mesentery detached approach applied to closure of loop ileostomy.BMC surgery · 2022Article
- Anterolateral thigh flaps in closing large abdominal wall defect after the resection of mucinous adenocarcinoma: a case report.BMC surgery · 2022Article
- Anastomotic Technique-How to Optimize Success and Minimize Leak Rates.Clinics in colon and rectal surgery · 2021Review
- Risk factors for postoperative ileus following loop ileostomy closure.Turkish journal of surgery · 2020Article
- Morbidity associated with closure of ileostomy after a three-stage ileal pouch-anal anastomosis.Updates in surgery · 2019Article
- Stringent fluid management might help to prevent postoperative ileus after loop ileostomy closure.Langenbeck's archives of surgery · 2019Article
- Effect of Biologic Material Reinforcement on Surgical Anastomosis After Gastrectomy-A Pilot Study.Frontiers in oncology · 2019Article
- Does advancement in stapling technology with triple-row and enhanced staple configurations confer additional safety? A matched comparison of 340 stapled ileocolic anastomoses.Surgical endoscopy · 2018Article
- Optimal literature search for systematic reviews in surgery.Langenbeck's archives of surgery · 2018Review
- A case report of laparoscopic duodenal atresia repair in a neonate using a novel miniature stapling device.International journal of surgery case reports · 2017Article
- Effect of Anti-TNF Agents on Postoperative Outcomes in Inflammatory Bowel Disease Patients: a Single Institution Experience.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2016Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThe aims of this study are to compare the 30-day rate of bowel obstruction for stapled vs. handsewn closure of loop ileostomy, and to further assess efficacy and safety for each technique by secondary endpoints such as operative time, rates of anastomotic leakage, and other post-operative complications within 30 days.
methodsA systematic literature search (MEDLINE, The Cochrane Library, EMBASE and ISI Web of Science) was performed to identify randomized controlled trials (RCTs) comparing stapled and handsewn closure of loop ileostomy after low anterior resection. Random effects meta-analyses were calculated and presented as risk ratio (RR) and mean difference (MD) with corresponding 95 % confidence intervals.
resultsForty publications were retrieved and 4 RCTs (649 patients) were included. There was methodological and clinical heterogeneity of included trials, but statistical heterogeneity was low for most endpoints. Stapler use significantly reduced the rate of bowel obstruction compared to hand-sewn closure (RR 0.53 [0.32, 0.88]; P = 0.01). The operation time was significantly lower for stapling compared to hand suture (MD -15.5 min [-18.4, 12.6]; P < 0.001). All other secondary outcomes did not show significant differences.
conclusionsThis meta-analysis shows superiority of stapled closure of loop ileostomy compared to handsewn closure in terms of bowel obstruction rate and mean operation time. Other relevant complications such as anastomotic leakage are equivalent. Even so, both techniques are options with opposing advantages and disadvantages.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.