A Comparative Study Between Stapler Versus Handsewn Anastomosis in Gastrointestinal Surgery

Abstract

Objective: To contrast outcome of hand-sewn and stapler anastomosis in gastro intestinal surgeries in terms of ‘time required for anastomoses, postoperative complications and Hospital stay.

Methodology: This comparative study was done at Surgical Unit-II, LUH, Jamshoro, on patients aged >18 years, who underwent gastro intestinal surgery scheduled for elective and emergency stapler or hand-sewn anastomosis, of either gender. After diagnosis the patients were randomly selected for both groups Stapler Anastomosis (group A) and hand-sewn Anastomosis (group B). Patients were assessed for time taken during anastomosis, postoperative complications, operative time and post-operative hospital stay. All the data was entered and analyzed by SPSS version 23.

Results: Mean age of cases in stapler anastomosis was 35.74±16.4 years and in hand-sewn Anastomosis was 31.62±14.96 years. Mean operative time in stapler anastomosis was significantly less compared to hand-sewn Anastomosis 35.35±5.34 hours and 60.31±10.29 hours respectively, (P-0.001). Hand–sewn anastomosis gained significantly longer time than stapler anastomosis, 27.10±5.95 minutes and 3.73±1.86 minutes respectively, (P- 0.001). Additionally, postoperative complications were higher among hand-sewn group, as; 17 wound infection cases and 3 anastomosis leakage in stapler anastomosis group, and 22 cases of wound infection, 6 cases of anastomosis leakage, and 3 abdominal abscess cases were in hand-sewn anastomosis group. Subsequently the Hospital stay was significantly higher among hand-sewn group as 10.76±2.24 days as compare to stapler anastomosis 5.58±1.36 days, (P-0.043).

Conclusion: The stapler anastomosis concluded to be a safe, reliable, and adaptable surgical tool, with shorter operative time, decreased complications rate and shorter Hospital stay in contrast to handsewn anastomosis.