Stapled versus Sutured Gastrointestinal Anastomoses in the Trauma Patient: A Multicenter Trial

Abstract

Anastomotic leaks and intra-abdominal abscesses appear to be more likely with stapled bowel repairs compared with sutured anastomoses in the injured patient. Caution should be exercised in deciding to staple a bowel anastomosis in the trauma patient.

The role of video-assisted laparoscopy in management of patients with small bowel injuries in abdominal trauma

“…On the other hand those wounds disposed along the longitudinal axis can be readily sutured [14]. The stapling technique has no advantage over suturing [15]. Therefore the later was used in all our patients.…”

A comparison of gastrojejunal anastomoses with or without buttressing in a porcine model

“…Some researchers have reported significantly higher complications in stapled compared with hand-sewn anastomoses in various patient groups, such as trauma patients [21,22]. Various materials have been proposed to buttress stapled anastomoses to help prevent anastomotic bleeding and leakage.…”

Gastrointestinal tract perforation following blunt abdominal trauma: an institution’s experience

“…While stapled anastomosis has been associated with an increased rate of post-operative complications such as intra-abdominal abscess and anastomotic dehiscence with leakage [3], the ease and speed of which it can be performed could be vital in any critically injured patient. The increased complication rates have been postulated to be due to the edematous bowel from the initial injury or from the resultant fluid resuscitation.…”

“…With the increasing adoption of non-operative management for blunt abdominal trauma [2], the accurate diagnosis of any perforation is of paramount importance, as delay could result in a higher incidence of morbidity [1]. Furthermore, there is no consensus on the most optimal surgical method in tackling the perforation [3]. Thus, the aims of our study were to review our institution's experience in managing GIT perforation following blunt abdominal trauma and to highlight the pertinent issues surrounding this problem.…”