A Comparative Study on the Outcome of Stapler Anastomosis vs. Hand-Sewn Anastomosis in Elective Gastrointestinal Surgeries

Abstract

BACKGROUND Gastrointestinal anastomosis plays a pivotal role in gastrointestinal surgeries. GI anastomosis can be done either by hand-sewn or stapler method. Recently stapling devices have created a great impact in GI anastomosis. Aim of this study is to compare the outcome of stapler versus hand-sewn anastomosis in elective GI surgeries. MATERIALS AND METHODS In this study, 50 patients requiring elective GI surgeries were included after satisfying the inclusion criteria. Patients were divided into four groups based on the site of anastomosis. Comparison between hand-sewn and stapled anastomosis in each group in terms of duration of anastomosis, duration of surgery, return of bowel activity, starting of oral feeds, acute postoperative complications and length of post-operative hospital stay were done. RESULTS In this study, we found significant difference between hand-sewn and stapler anastomosis in each group in terms of duration of anastomosis, duration of surgery, return of bowel activity, oral feeds starting day and length of postoperative hospital stay. It was stapled anastomosis that took lesser time for anastomosis, total operating time, return of bowel activity and length of hospital stay. Chi-square test was used to differentiate acute post-operative complications, which was insignificant between hand-sewn and stapler method with p-value > 0.05. CONCLUSION Due to shortened operating time, staplers are favourable for patients with poor general condition who would not tolerate prolonged anaesthesia. The insignificant difference in acute postoperative complications suggests both hand-sewn and stapled method can be done with same safety and accuracy when done with proper technique.