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European Spine Journal
Published in: European Spine Journal 7/2017

01-07-2017 | Review Article

The efficacy of bipolar sealer on blood loss in spine surgery: a meta-analysis

Authors: Tao Lan, Shi-yu Hu, Xin-Jian Yang, Yang Chen, Yi-Yan Qiu, Wei-zhuang Guo, Jian-ze Lin, Kai Ren

Published in: European Spine Journal | Issue 7/2017

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Abstract

Objective

The purpose of this meta-analysis of randomized controlled trials (RCTs) and non-RCTs was to gather data to evaluate the efficacy and safety of bipolar sealer versus standard electrocautery in the management of spinal disease.

Methods

The electronic databases including Embase, PubMed and Cochrane library were searched to identify relevant studies published from the time of the establishment of these databases up to January 2017. The primary outcomes were total blood loss, requirement of transfusion (rate and amount), and operation time. The secondary outcomes were length of hospital stay and postoperative wound infection. Data analysis was conducted with RevMan 5.3 software.

Results

A total of five studies involving 500 patients (261 patients in the BS group and 239 in the control group) were included in the meta-analysis. The pooled results revealed that application of bipolar sealer could decrease the total blood loss in spine surgery [WMD = −467.49, 95% CI (685.47 to −249.51); p < 0.05; I 2 = 91%]. Compared with standard electrocautery, bipolar sealer was associated with lower rates of need for transfusion [OR = 0.30, 95% CI (0.16–0.55), p < 0.05; I 2 = 0%]. In addition, patients in the BS group were likely to receive less amount of blood transfusion compared with patients in the control group[WMD = −0.73, 95% CI (−1.37 to −0.09), p < 0.05; I 2 = 76%]. The mean operative time was shorter in the BS groups compared with the control group [SMD = −0.36, 95% CI (−0.60 to −0.13), p < 0.05; I 2 = 0%]. There was no significant difference in terms of length of hospital stay [WMD = −0.73, 95% CI (−1.96 to 0.51), p = 0.25; I 2 = 67%] and postoperative wound infection [OR = 0.88, 95% CI (0.31–2.48), p = 0.81; I 2 = 0.0%] between both groups.

Conclusions

The available evidence suggests that bipolar sealer is superior to standard electrocautery with less blood loss, shorter operation time and less transfusion requirement. There is no significant difference between both groups regarding length of hospitalization and wound infection. Hence, bipolar sealer is recommended in spine surgery. Because of the limitation of our study, more well-designed RCTs with large sample are required to provide further evidence of safety and efficacy between bipolar sealer and standard electrocautery in the treatment of spinal disease.
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Metadata
Title
The efficacy of bipolar sealer on blood loss in spine surgery: a meta-analysis
Authors
Tao Lan
Shi-yu Hu
Xin-Jian Yang
Yang Chen
Yi-Yan Qiu
Wei-zhuang Guo
Jian-ze Lin
Kai Ren
Publication date
01-07-2017
Publisher
Springer Berlin Heidelberg
Published in
European Spine Journal / Issue 7/2017
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI
https://doi.org/10.1007/s00586-017-5045-3

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