Comparative study between hand sewn and stapled anastomosis in laparoscopic right hemicolectomy

Abstract

Laparoscopy has emerged as the preferred operative approach for most intra-abdominal pathologic conditions. Nonetheless, even though the first laparoscopic colectomy was reported more than 20 years ago. 2 Laparoscopic hemicolectomy for colonic cancer can be performed safely with morbidity, mortality and long-term results comparable to those of open surgery. 3 ABSTRACT Background: Laparoscopic hemicolectomy for colonic cancer can be performed safely with morbidity, mortality and long-term results comparable to those of open surgery. Despite these advantages, laparoscopic right hemicolectomy is technically challenging and warrants intensive structured training to minimize conversion to open surgery and associated complications. Anastomosis could be done either by hand sewn or stapler. Methods: Present study was a prospective study. It included 30 patients presented to Menoufia University Hospital and El Salam Oncology Center with carcinoma of right colon from March 2016 until September 2018. The patients were divided into two groups each group of 15 patients. In the first group, author used the hand sewing for anastomosis compared to the stapled anastomosis in the second group. Results: In the first group, 11 of them were males (73.3%) and 4 were females (26.7 %) with the mean age was 55.93±8.64 years. In the second group, 6 of them were males (40%) and 9 were females (60%) with the mean age was 48.33±17.97 years. In the first group, the mean time of anastomosis was 36.0±4.71 minutes and in the second group the mean time of anastomosis was 21.67±5.56 minutes. In the first group, 1 case was complicated by leakage from anastomosis (6.2%), 1 case was complicated by wound infection (6.2%). In the second group, there was no complication. Conclusions: In this study, the main advantages of doing a stapled anastomosis are the operative time, hospital stay and intraoperative bleeding. Postoperative complications than the hand sewn anastomosis.

Outcomes Assessment between Hand Sewn and Stapled Intestinal Anastomosis

“…The patients who did not achieve the abovementioned standards were deferred to enterostomy. Same material of sutures including antibiotics cefuroxime 750 mg, 2/0 vicryl (polyglyactin) along with 8 hourly metronidazole 500 mg and gentamycin 80 mg were managed up to 5th day postoperatively [10]. All patients were assigned to two different groups A and B each encompassing of 35 cases.…”