A Comparative Study of Stapled Anastomosis and Hand-Sewn Anastomosis in GI Surgeries Based on Clinical Practice

Dr. Ajay Kumar; Dr. Chandan Kumar; Prof Dr. Ranjan George Baxla; Dr. Ram Das Nagesh; Dr. Gajendra Pandit

Volume : IX, Issue : VIII, August - 2020

A Comparative Study of Stapled Anastomosis and Hand-Sewn Anastomosis in GI Surgeries Based on Clinical Practice

Dr. Ajay Kumar, Dr. Chandan Kumar, Prof Dr. Ranjan George Baxla, Dr. Ram Das Nagesh, Dr. Gajendra Pandit

Abstract :

Background: There is a lack of studies comp� stapled suturing and hand-sewn suturing in GI surgeries in tier 2 towns of India. Methods: Data were retrospectively collected from 499 patients who underwent GI surgeries. The patients were divided into two groups according to the method of digestive tract reconstruction: 296 patients received stapled suturing and 203 patients received hand-sewn suturing. The operation time, postoperative hospital stay, postoperative recovery and complications of the patients were evaluated and compared between the two groups. Results: The stapling procedure took shorter operative time compared to the hand-sewn procedure for gastric carcinoma, colorectal cancer and esophageal carcinoma (P < 0.05). There was no significant difference between the two groups in postoperative hospital stay (P > 0.05). Patients receiving hand sewn suturing also showed shorter recovery for gastric cancer, colorectal cancer, and shorter time to recovery of normal gastrocolorectal motility compared with patients in the stapled suturing group (P < 0.05) in rural areas. However, there was no difference between the two groups in terms of normal time to commencing liquid diet for esophageal cancer patients (P > 0.05). We also found that the stapled procedure showed a lower incidence of anastomotic leakage, anastomotic hemorrhage and stump leakage in treating colorectal cancer or gastric carcinoma compared with the hand-sewn procedure (P < 0.05).However the cost of staplers was too high for patients in tier 2 towns making in unaffordable for most of them. Conclusions: Application of the stapler in GI surgeries demonstrated no better effects on patients in terms of surgical operation time, recovery time to normal functions, and occurrence of complications compared to hand- sewn anastomosis, especially in gastric carcinoma and colorectal cancer.