Background

The efficacy of most staple line reinforcement methods (SLR), such as Seamguard buttressing (SGB), fibrin gluing, oversewing/suturing (OS/S), and omentopexy/gastropexy, in preventing leaks and postoperative bleeding is supported in the literature. However, the comparative efficacy of Bovine Pericardial Strips/Peri-Strip Dry (BPS/PSD) buttressing against no-SLR and other SLR methods remains unclear.

Methods

We conducted a systematic literature review following PRISMA guidelines. Utilizing the random effects model, odds ratios were employed for dichotomous data, and mean differences were used for continuous data as effect size metrics.

Results

In comparison to no-SLR, BPS/PSD buttressing appears to significantly reduce the incidence of postoperative leaks (p = 0.01) and bleeding (p = 0.01). When compared to OS/S or SGB, BPS/PSD buttressing shows similar lengths of stay and rates of postoperative leaks and bleeding. However, compared to SGB, BPS/PSD appears to be associated with a higher incidence of readmissions (p = 0.05) and reoperations (p < 0.00001). Similarly, compared to OS/S, BPS/PSD appears to have a higher incidence of readmissions (p = 0.06) but not reoperations (p = 0.10).

Conclusions

This study suggests that BPS/PSD buttressing might effectively reinforce the staple line compared to no reinforcement. However, due to study limitations, reliable conclusions, especially in comparing BPS/PSD buttressing with other SLR methods, cannot be drawn. Therefore, further research in this area is strongly recommended.