Meta-Analysis:

ABSTRACT

To evaluate the efficacy and safety of bipolar sealer for the reduction of intraoperative blood loss and transfusion requirements for patients undergoing major orthopedic surgery, including total knee arthroplasty (TKA), total hip arthroplasty (THA), and spinal surgery. Electronic databases, including PubMed, Embase, CENTRAL (Cochrane Controlled Trials Register), Web of Science and Google scholar, were searched within a date range from their inception up to November 2016. The intraoperative blood loss, hemoglobin drop, operation time and length of hospital stay were calculated as the weighted mean difference (WMD) with a 95% confidence interval (CI), and the need for transfusion as well as the occurrence of infection were calculated as relative risk (RR) with a 95% CI. The results indicated that bipolar sealer can decrease intraoperative blood loss (WMD = -105.30, 95% CI -169.17~-41.43; P < 0.00001), the need for a transfusion (RR, 0.68; 95% CI, 0.53~0.86; P = 0.001), and hemoglobin drop (WMD, -0.14; 95% CI, -0.27–0.00; P = 0.05). There were no significant differences between operation time, the length of the hospital stay and the occurrence of infection (P > 0.05). Compared to standard electrocautery, bipolar sealer can effectively reduce intraoperative blood loss and subsequent blood transfusion without increasing the rate of infections.