Hand sewn versus stapler anastomosis in elective gastro intestinal surgeries

Abstract

Background: The technique for intestinal anastomosis in elective gastrointestinal surgeries depends on site, bowel calibre and underlying disease. The decision to choose hand sewn or stapler anastomosis depends on surgical experience and preference. The objective of this study was to study the outcome of hand sewn anastomosis compared with stapler anastomosis in elective gastrointestinal surgeries.Methods: Retrospective comparative study was conducted in surgical wards of a tertiary referral hospital from July’2013 to June’2016. Data analysed with independent samples T-test to compare mean values between methods and Chi-square tests used to compare proportion of the two values.Results: Significant difference in duration of procedure, return of bowel sounds, starting of oral feeds, hospitalization days, return to work noted in stapler anastomosis compared with hand sewn anastomosis in subtotal gastrectomy and gastrojejunostomy. No difference in appearance of bowel sounds in right hemicolectomy and other resection and anastomoses group, no difference in return to work in right hemicolectomy group, no difference in starting of oral feeds in low anterior resection group. Other parameters were statistically significant in right hemicolectomy, low anterior resection and other resection and anastomosis groups. No significant difference observed in anastomotic leak between hand sewn and stapler methods. There was no mortality in stapler group.Conclusions: Stapler method significantly reduces duration of surgery, has early recovery with less mortality. Stapling is quick to perform in inaccessible situations like low colorectal anastomosis. Stapler anastomosis can be used safely and effectively in elective gastrointestinal surgeries.