Staples or sutures for low colorectal anastomoses: A prospective randomized trial

Abstract

One hundred and eighteen patients undergoing low colorectal anastomoses were randomly allocated to reconstitution by either single layer interrupted extramucosal sutures or circular staple gun. In the 60 patients undergoing sutured anastomosis there were 2 (3 per cent) clinical leaks and 4 (7 per cent) radiological leaks, and no failures. Of the 58 patients who underwent stapled anastomosis there were 4 failures, 7 (12 per cent) clinical leaks, 14 (24 per cent) radiological leaks and 1 death. Stapled anastomoses were more than ten times as expensive as sutured anastomoses and there were no savings in time or numbers of associated colostomies. An interrupted extramucosal suture technique remains the ultimate standard for low colorectal anastomosis.

Long-Term Results after 75 Anastomoses in the Upper Extraperitoneal Rectum with the Biofragmentable Anastomosis Ring

“…Concerning hand-sutured rectum anastomoses the reported leakage rate ranges from 0 to 20%, depending on the suture technique [21, 22, 23]. Comparative studies show a leakage rate of 0–12% after stapling and 3–27% after hand suture [24, 25]. These data suggest comparable results of stapled and hand-sutured anastomoses with the BAR technique with respect to anastomotic leakage.…”

A prospective randomized trial of hand-sutured versus mechanically stapled anastomoses for gastroduodenostomy after distal gastrectomy

“…Mechanical staplers have shortened the operation time, facilitated the performance of gastrointestinal anastomoses at sites with a poor field of view, and lowered the likelihood of suture failure [1][2][3]. Several prospective, randomized controlled studies have compared hand suturing with mechanical stapling in patients undergoing total gastrectomy and low anterior colorectal resection [1,[4][5][6][7][8][9][10].…”

Anastomotic dehiscence after colorectal surgery

“…7 However it is advisable to perform a single layer anastomosis when it involves the lower colon and rectum. With the advent of staplers, lower colorectal anastomoses are routinely being done by stapling.…”