Outcome Comparison of Stapled Versus Hand-Sewn Anastomosis in Elective Gastrointestinal Surgeries: Stapled Versus Hand-Sewn Anastomosis in Elective Gastrointestinal Surgeries

Muhammad  Tariq Ghafoor; Sohail  Sabir; Rukhsana  Tumrani; Noreen  Kauser; S. Sabahat  Haider

doi:10.54393/pjhs.v3i04.154

Authors

Muhammad Tariq Ghafoor Department of General Surgery, SZMC, Rahim Yar Khan, Pakistan
Sohail Sabir Department of General Surgery, SZMC, Rahim Yar Khan, Pakistan
Rukhsana Tumrani Department of Chemical Pathology, SZMC, Rahim Yar Khan, Pakistan
Noreen Kauser Department of General Surgery, SZMC, Rahim Yar Khan, Pakistan
S. Sabahat Haider Department of Chemical Pathology, SZMC, Rahim Yar Khan, Pakistan

DOI:

https://doi.org/10.54393/pjhs.v3i04.154

Keywords:

Stappled anastomosis, Hand sewn anastomosis, Elective Gastrointestinal Surgeries

Abstract

Bowel loop anastomosis is considered as major part of elective gastrointestinal surgeries. The anastomotic procedures being used now a days include hand sewn and stapled anastomosis. For appropriate gastrointestinal anastomosis, many factors should be considered such as intraoperative duration, restoration of blood supply, restoration of normal function of gastrointestinal tract and decrease tissue damage. Objective: The objective of the study was to compare the outcome of stapler and hand sewn anastomosis in elective gastrointestinal surgeries. Methods: Cross-sectional observational study conducted in department of surgery, Sheikh Zayed Hospital, Rahim Yar Khan from May 1, 2021 to August 31, 2022. Total 60 patients included in study and outcome variables such as anastomotic integrity, duration of procedure, post-operative hospital stay and return of bowel activity compared in hand sewn and stapled anastomosis. Results: The study included total 60 patients out of which 38 (63.33%) underwent stapled anastomosis and 22 (36.66%) underwent hand sewn anastomosis. Age (P value: 0.373), gender (p value: 0.372), anastomotic site (p value: 0.284) and return of bowel activity (p value: 0.331) did not show statistically significant difference between two groups. Anastomotic integrity (p value: 0.025), duration of procedure (p value: 0.002), post-operative hospital stay (p value: 0.037) show statistically significant difference between hand sewn and stapled anastomosis. Conclusions: Stapled anastomosis has better anastomotic integrity, reduced duration of procedure and decreased post-operative hospital stay as compared to hand sewn anastomosis with statistically significant difference between two groups.

References

Liu BW, Liu Y, Liu JR, Feng ZX. Comparison of hand-sewn and stapled anastomoses in surgeries of gastrointestinal tumors based on clinical practice of China. World journal of surgical oncology. 2014 Sep; 12:292. doi: 10.1186/1477-7819-12-292.

Mitra AS, Chandak U, Kulkarni KK, Nagdive N, Saoji R, Tiwari C. Stapled vs Conventional Hand-sewn Gastrointestinal Anastomosis during Infancy: A Prospective Comparative Study from Central India. Euroasian Journal of Hepato-Gastroenterology. 2020 Jun; 10(1):11-15. doi: 10.5005/jp-journals-10018-1308.

Khan AQ, Awan N, Dar WR, Mehmood M, Latief M, Sofi N, Dar I, Sofi P, et al. Surgical outcome of stapled and handsewn anastomosis in lower gastrointestinal malignancies: A prospective study. Archives of International Surgery. 2016 Jan; 6(1):1.

Thakor RB, Kansal SS, Salecha PA. A comparative study of Hand suture verses Stapler Anastomosis Gastrointestinal surgeries. National Journal of Medical Research. 2014 Dec; 4(04):354-6.

Banurekha R, Sadasivam S, Sathyamoorthy K. Hand sewn versus stapler anastomosis in elective gastro intestinal surgeries. International Surgery Journal. 2017 Jun; 4(7):2316-20.

Nichkaode PB and Parakh A. Stapling devices: comparative study of stapled versus conventional hand sewn anastomosis in elective gastrointestinal surgery. International Surgery Journal. 2017 Aug; 4(9):2937-42.

Bangaru H, Veitla RM, Pigilam M, Kunwargiri GK. Comparative Study between Staplers and Conventional(Hand-Sewn) Anastomosis in Gastrointestinal Surgery. Indian journal of surgical oncology. 2012 Dec; 74(6):462-7. doi: 10.1007/s12262-012-0450-7.

Venkatareddy C, Kumar A, Sindhu. “Comparative Study of Handsewn Anastomosis and Stapler Anastomosis in Elective Gastrointestinal Surgery.” IOSR Journal of Dental and Medical Sciences (IOSR-JDMS), 19(12):2020;40-42.

Hardy KJ. Non-suture anastomosis: the historical development. ANZ journal of surgery. 1990 Aug; 60(8):625-33. doi: 10.1111/j.1445-2197. 1990.tb07444. x.

Zeebregts CJ, Heijmen RH, van den Dungen JJ, van Schilfgaarde R. Non-suture methods of vascular anastomosis. British Journal of Surgery. 2003 Mar; 90(3):261-71. doi: 10.1002/bjs.4063.

Burch JM, Franciose RJ, Moore EE, Biffl WL, Offner PJ. Single-layer continuous versus two-layer interrupted intestinal anastomosis: a prospective randomized trial. Annals of surgery. 2000 Jun; 231(6):832-7. doi: 10.1097/00000658-200006000-00007.

Kim DH, Hong SC, Jang JY, Cho JK, Ju YT, Lee YJ, et al. Comparing the surgical outcomes of stapled anastomosis versus hand-sewn anastomosis of duodenojejunostomy in pylorus-preserving pancreaticoduodenectomy. Journal of hepato-biliary-pancreatic sciences. 2019 Aug; 23(3):245-251. doi: 10.14701/ahbps.2019.23.3.245.

Guyton KL, Hyman NH, Alverdy JC. Prevention of Perioperative Anastomotic Healing Complications: Anastomotic Stricture and Anastomotic Leak. Journal of surgical orthopaedic advances. 2016 Sep; 50(1):129-41. doi: 10.1016/j.yasu.2016.03.011.

Hintz GC, Alshehri A, Bell CM, Butterworth SA. Stapled versus hand-sewn pediatric intestinal anastomoses: A retrospective cohort study. Journal of pediatric surgery. 2018 May; 53(5):959-963. doi: 10.1016/j.jpedsurg.2018.02.021.

Naumann DN, Bhangu A, Kelly M, Bowley DM. Stapled versus handsewn intestinal anastomosis in emergency laparotomy: a systemic review and meta-analysis. Surgery. 2015 Apr; 157(4):609-18. doi: 10.1016/j.surg.2014.09.030.

Rasihashemi SZ, Ramouz A, Beheshtirouy S, Amini H. Comparison of end-to-side hand-sewn and side-to-side stapled cervical esophagogastric anastomosis in patients with lower thoracic esophageal cancer undergoing transhiatal esophagectomy: an Iranian retrospective cohort study. BMC Gastroenterology. 2020 Jul; 20(1):250. doi: 10.1186/s12876-020-01393-x.

Harustiak T, Pazdro A, Snajdauf M, Stolz A, Lischke R. Anastomotic leak and stricture after hand-sewn versus linear-stapled intrathoracic oesophagogastric anastomosis: single-centre analysis of 415 oesophagectomies. European Journal of Cardio-Thoracic Surgery. 2016 Jun; 49(6):1650-9. doi: 10.1093/ejcts/ezv395.

Hemming K, Pinkney T, Futaba K, Pennant M, Morton DG, Lilford RJ. A systematic review of systematic reviews and panoramic meta-analysis: staples versus sutures for surgical procedures. PLoS One. 2013 Oct 7;8(10): e75132. doi: 10.1371/journal.pone.0075132.

Gong J, Guo Z, Li Y, Gu L, Zhu W, Li J, et al. Stapled vs hand suture closure of loop ileostomy: a meta-analysis. International journal of colorectal disease. 2013; 15(10): e561-8. doi: 10.1111/codi.12388.

Hussain T, Jabbar A, Ahmed N, Shah N, Zulfiqar M. The Comparison of Hand Sewn and Stapled Anastomoses. Pakistan Armed Forces Medical Journal (PAFMJ). 2022 Jun; 72(3):1004-07.

Mitra AS, Chandak U, Kulkarni KK, Nagdive N, Saoji R, Tiwari C. Stapled vs Conventional Hand-sewn Gastrointestinal Anastomosis during Infancy: A Prospective Comparative Study from Central India. Euroasian Journal of Hepato-Gastroenterology. 2020Jun;10(1):11-15. doi: 10.5005/jp-journals-10018-1308.

Catena F, La Donna M, Gagliardi S, Avanzolini A, Taffurelli M. Stapled versus hand-sewn anastomoses in emergency intestinal surgery: results of a prospective randomized study. Surgery Today. 2004; 34(2):123-6. doi: 10.1007/s00595-003-2678-0.

Karthikeyan S, Balasubramanian S, Siddarthan R, Sarath RS. Stapler Suturing Vs Conventional Suturing-A Comparitive Study on the Outcome of Wound Closure in Abdominal Skin Incisions. AGE (n= 100). 2018 Feb; 44:14-9.

Espin E, Vallribera F, Kreisler E, Biondo S. Clinical impact of leakage in patients with handsewn vs stapled anastomosis after right hemicolectomy: a retrospective study. International journal of colorectal disease. 2020 Oct; 22(10):1286-1292. doi: 10.1111/codi.15098.

Ji W, Chandoo A, Guo X, You T, Shao Z, Zheng K, et al. Enhanced recovery after surgery decreases intestinal recovery time and pain intensity in patients undergoing curative gastrectomy. International journal of cancer management. 2018 Sep; 10:3513-3520. doi: 10.2147/CMAR.S168909.