A prospective study of outcome of resection anastomosis in elective GI surgeries.

  • Dr. Abhilash N Assistant professor, Department of General Surgery, BGS GIMS, Bengaluru, Karnataka, India
  • Dr. Venugopal KJ Assistant professor, Department of General Surgery, Adichunchungiri Institute of Medical Sciences, Mandya, Karnataka, India
  • Dr. Srikanth K Aithal Senior Consultant, Department of General Surgery, St Martha’s Hospital, Bengaluru, Karnataka, India
Keywords: Surgical anastomosis, Surgical staples, Operative time

Abstract

Background: Bowel anastomosis is successful when there is accurate union with no tension. Previous literature has compared between hand suturing and stapling devices in retrospective and prospective designs with varying outcomes. In this study a comparison between hand suturing and surgical stapling in patients undergoing bowel surgery is done.

Methods: A prospective study design over a period of 12 months was conducted in 40 patients undergoing elective resection and anastomosis. Different time parameters for anastomisis procedure, time taken for bowel sounds to return, resumption of oral feeds, postoperative hospital stay were collected. Follow up for 30 days post-operative was done.

Results: In total forty patients were studied out of which twenty patients underwent hand sewn and twenty patients underwent stapler anastomosis. Main group analysis in mean time durations between hand sewn and stapler anastomosis were respectively; 35.25 minutes and 12 minutes for anastomosis, 3.4 days and 3.35 days for return of bowel sounds, 4.08 days and 4 days for resumotion of oral feeds, 9.35 days and 8.50 days for post-operative hospital stay. A sub-group analysis was also done.

Conclusion: Stapler anastomosis had shorter anastomosis time and total duration of operation compared to hand sewn anastomosis. However no difference was seen in return of bowel activity, resumption of oral feeds and duration of hospital stay.

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References

Kirk R, Winslet M. Essential general surgical operations. Edinburgh: Elsevier/Churchill Livingstone; 2010. p. 71-5.

Lustosa SA, Matos D, Atallah AN, Castro AA. Stapled versus handsewn methods for colorectal anastomosis surgery. Cochrane Database Syst Rev. 2001;(3):CD003144. doi: 10.1002/14651858.CD003144.

MacRae HM, McLeod RS. Handsewn vs. stapled anastomoses in colon and rectal surgery: a meta-analysis. Dis Colon Rectum. 1998 Feb;41(2):180-9. doi: 10.1007/BF02238246.

Murthy, V., Pai, M. V., Bhat, R., & Thejeswi, PC. Comparative study of hand sutures versus staplers in elective gastric surgeries in a south Indian population. The Internet Journal of Surgery, 30.2. (2013).

Choy PY, Bissett IP, Docherty JG, Parry BR, Merrie AE. Stapled versus handsewn methods for ileocolic anastomoses. Cochrane Database Syst Rev. 2007 Jul 18;(3):CD004320. doi: 10.1002/14651858.CD004320.

Brooks DC, Zinner MJ. Surgery of the small and large bowel. In: Zinner MJ, Ellis H. Maingot‘s abdominal operations. 10th edition. Connecticut (USA): Applleton and Lange; 2000; p.1321–30.

Leaper, David J. "Basic surgical skills and anastomoses." Bailey & Love's Short Practice of Surgery. CRC Press, 2008. 252-264.

Kirk, Raymond Maurice. Basic Surgical Techniques E-Book. Elsevier Health Sciences, 2010.

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

Damesha, N., Lubana, P. S., Jain, D. K., & Mathur, R. A comparative study of sutured and stapled anastomosis in gastrointestinal operations. Internet J Surg, 15.2 (2008): 8.

George, W. D. "Suturing or stapling in gastrointestinal surgery: a prospective randomized study." Journal of British Surgery 78.3 (1991): 337-341.

Hollender LF, Blanchot P, Meyer C, da Silva e Costa JM. Erfahrungen mit der Anwendung von Nähapparaten in der Magen-Darm-Chirurgie [Mechanical suturing apparatus in gastro-intestinal surgery (author's transl)]. Zentralbl Chir. 1981;106(2):74-83. German.

Choy PY, Bissett IP, Docherty JG, Parry BR, Merrie A, Fitzgerald A. Stapled versus handsewn methods for ileocolic anastomoses. Cochrane Database Syst Rev. 2011 Sep 7;(9)CD004320. doi: 10.1002/14651858.CD004320.pub3

Deng XF, Liu QX, Zhou D, Min JX, Dai JG. Hand-sewn vs linearly stapled esophagogastric anastomosis for esophageal cancer: a meta-analysis. World J Gastroenterol. 2015 Apr 21;21(15):4757-64. doi: 10.3748/wjg.v21.i15.4757.

Scher KS, Scott-Conner C, Ong WT. A comparison of stapled and sutured anastomoses in gastric operations. Surg Gynecol Obstet. 1982 Apr;154(4):548-52.

Reiling RB, Reiling WA Jr, Bernie WA, Huffer AB, Perkins NC, Elliott DW. Prospective controlled study of gastrointestinal stapled anastomoses. Am J Surg. 1980 Jan;139(1):147-52. doi: 10.1016/0002-9610(80)90244-5.

CITATION
DOI: 10.17511/ijoso.2021.i03.05
Published: 2021-08-13
How to Cite
Dr. Abhilash N, Dr. Venugopal KJ, & Dr. Srikanth K Aithal. (2021). A prospective study of outcome of resection anastomosis in elective GI surgeries. Surgical Review: International Journal of Surgery, Trauma and Orthopedics, 7(3), 67-72. https://doi.org/10.17511/ijoso.2021.i03.05
Section
Original Article