Stapled versus handsewn methods for ileocolic anastomoses

Choy, Pui Yee Grace; Bissett, Ian P.; Docherty, James; Parry, Bryan R.; Merrie, Arend E. H.

doi:10.1002/14651858.cd004320.pub2

Cited by 93 publications

(60 citation statements)

References 33 publications

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“…Intraoperative problems and postoperative strictures seem to be more frequent in stapled anastomosis [118]. However, in a recent Cochrane review ileocolic stapler anastomoses were associated with fewer leaks than handsewn anastomoses [119]. …”

Section: Complicationsmentioning

confidence: 99%

Complications in colorectal surgery: risk factors and preventive strategies

2010

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BackroundOpen or laparoscopic colorectal surgery comprises of many different types of procedures for various diseases. Depending upon the operation and modifiable and non-modifiable risk factors the intra- and postoperative morbidity and mortality rate vary. In general, surgical complications can be divided into intraoperative and postoperative complications and usually occur while the patient is still in the hospital.MethodsA literature search (1980-2009) was carried out, using MEDLINE, PubMed and the Cochrane library.ResultsThis review provides an overview how to identify and minimize intra- and postoperative complications. The improvement of different treatment strategies and technical inventions in the recent decade has been enormous. This is mainly attributable to the increase in the laparoscopic approach, which is now well accepted for many procedures. Training of the surgeon, hospital volume and learning curves are becoming increasingly more important to maximize patient safety, surgeon expertise and cost effectiveness. In addition, standardization of perioperative care is essential to minimize postoperative complications.ConclusionThis review summarizes the main perioperative complications of colorectal surgery and influencable and non-influencable risk factors which are important to the general surgeon and the relevant specialist as well. In order to minimize or even avoid complications it is crucial to know these risk factors and strategies to prevent, treat or reduce intra- and postoperative complications.

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Section: Complicationsmentioning

confidence: 99%

Complications in colorectal surgery: risk factors and preventive strategies

2010

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“…Two of them were included in the systematic review (7,8) and one was a systematic review per se (9). With the additional search we selected more articles (10).…”

Section: Colorectal Surgerymentioning

confidence: 99%

“…The authors found no relevant clinical differences between the two methods, although intraoperative technical problems and postoperative strictures were more common with stapled anastomoses. A recent meta-analysis, published in Cochrane Library, focused on the outcomes after right colectomy and ileocolic anastomosis performed for right-sided colon cancer and Crohn's disease (9). Stapled anastomosis was associated with significantly fewer anastomotic leaks (1,4%), compared with the handsewn (6 %).…”

Section: Colorectal Surgerymentioning

confidence: 99%

The current evidence on stapled versus hand‐sewn anastomoses in the digestive tract

Korolija

2008

Minimally Invasive Therapy & Allied Technologies

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The innovation process and developments in technology have given surgeons new products which can improve their performance and benefit our patients. Before the era of laparoscopic surgery one of the most important applications in surgical practice was the introduction of staplers. In this article, the evidence supporting the decision whether to use a mechanical device (stapler) or to make a hand-sewn anastomosis is presented. A sytematic review of the literature was performed. The search included published meta-anaylses, randomized clinical trials and comparative studies. Key words for the initial search were: surgical anastomosis, stapler, hand-sewn. There was no language restriction. The reference lists from the selected articles were also checked by the author. Literature data on main outcomes concerning the application of one or the other surgical technique have been analysed. The literature search yielded published data on various procedures in digestive surgery. Most of the available high-quality evidence was for gastric and colorectal resections. Resection of the esophagus, use of staplers in emergency procedures and some initial reports on pancreatic surgery were also retrieved. The evidence from the literature shows that stapler anastomoses take less operative time and are more costly than hand-sewn anastomoses. Regarding the morbidity and leaks rate the staplers give equal or better results when compared with the hand-sewn technique. Nevertheless, proper handling of staplers and experience remain crucial issues if one wants to gain benefits when using these devices.

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“…Another recent study of 53 cases identified risk factors for dehiscence of stapled anastomoses, including the presence, duration, and number of intraoperative hypotensive periods, as well as colonic resection and anastomosis . Human patients with surgical indications for IRA, such as emergency general surgery, septic peritonitis, ileocolic anastomoses, or anastomoses in trauma patients have been proposed to benefit from selective techniques . The application of similar evidence‐based selective techniques in specific veterinary patients could reduce complications in companion animals.…”

Section: Introductionmentioning

confidence: 99%