ISSN 2321–3647
Tue, 26 Sep 2017

A Prospective Comparative Study of Hand Sewn Versus Stapler Gastrointestinal Anastomosis

Dharmraj Meena1*, Rinkesh Meena2

1. Department of Surgery Govt. Medical College, Kota (Raj.)

2. Medical Officer, Govt. Hospital, Baran (Raj.)


ABSTRACT

Leak from Gastrointestinal anastomosis following resection is associated with morbidity.  To address this issue, we conducted a randomized trial comparing "hand-sewn" with "stapled " anastomosis. The cases were randomly allocated depending on the affordability and availability of instrument for the procedure .A detailed history and the routine and specified investigations were carried out and the details about operation were recorded. Proper post operative  care and careful observations done. Two group made (i) Stapled and (ii) Hand Sewan 25 patients in each group. The primary outcome measure was anastomotic leak rate. Secondary outcome were duration of surgery, hospital stay and wound infection. The overall anastomotic leak rate was 14%. The leak rate was higher in hand sewn group(hand-sewn: 5/25, stapled: 2/25; p=<0.005). The stapled anastomotic technique was faster (8.5 ±.5 min vs. 25.4 ± 1.8 min; p=<0.05). In stapled bowel surgery the mean return of G.I. function occurred on 4.32th day and in hand sewn it was 5.32th or 1 day (24 hours) earlier when stapling technique was used (p. Value 0.0217) There were significant differences in the leak rates and postoperative outcome between the two techniques. The only concern is the financial issues specifically in India.

 


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