Comparative Study of Stapler Anastomosis Over Hand Sewn Anastomosis in Elective Gastrointestinal Surgeries

Abstract

Anastomosis in Gastrointestinal surgery is a very commonly performed procedure , since the era of Sushruta, various methods of intestinal anastomosis were followed-recent advancement is the use of stapler as a device for GI anastomosis. Because of the use of staplers technical failures is a rarity, anastomosis is more consistent, and can be used at difficult locations. MATERIALS AND METHODS: A total of 50 cases which met the inclusion and exclusion criteria were included in this hospital based prospective comparative study. The study population included all patients who underwent elective gastrointestinal surgeries. STUDY FACTORS: The subjects were allocated into two groups according to the type of anastomosis, hand sewn and stapler. Both hand sewn and stapled anastomosis were further divided into three sub-groups according to the site of anastomosis viz esophageal, gastrojejunal and colorectal. OUTCOME FACTORS: Anastomotic Integrity, Duration of operation, Return of Bowel activity, Hospital stay. RESULTS: A total of 50 patients with malignant or benign condition of bowel and esophagus, requiring anastomosis were allocated in study group of GI staplers and control group of conventional Hand sewn technique. Out of 50 cases there were 13 esophageal anastomosis, 19 gastrojejunostomies and 18 colorectal anastomosis CONCLUSION: In our present study, we found that stapling technique can significantly reduce the time for anastomotic procedure, less tissue trauma due to less tissue handling, there is early restoration of gastrointestinal function, early resumption of oral feeding and reduced duration of hospital stay which helps ultimately in early return to routine work, importantly staplers can be used at places were hand sewn anastomosis is technically difficult. Technique related complications do not show significant differences which suggests that one can use staplers with same safety and accuracy as sutures