Comparison Between Stapler and Hand Sewn  Anastomosis in Elective Gastrointestinal  Surgeries Conducted at Government Tertiary  Hospital, Western India: A Prospective Study

Dr. Gaurang Raiyani; Dr. Anish Vohra; Dr. Parag Chavda; Dr. Kedar Mehta; Dr. Alpesh Parmar

Volume : III, Issue : I, January - 2014

Comparison Between Stapler and Hand Sewn Anastomosis in Elective Gastrointestinal Surgeries Conducted at Government Tertiary Hospital, Western India: A Prospective Study

Dr. Gaurang Raiyani, Dr. Anish Vohra, Dr. Parag Chavda, Dr. Kedar Mehta, Dr. Alpesh Parmar

Abstract :

Background and objectives: Intestinal obstruction, peritonitis from a perforated bowel, abdominal trauma, malignancy of the gastrointestinal tract and other bowel diseases are common surgical problems throughout the world which must be treated operatively. Hence, it is frequently necessary to join two sections of bowel together. This anastomosis is carried out either manually or by using staplers. Many studies have different opinions about these two techniques. So this study is carried out with objectives to compare these two methods of anastomosis in terms of its complications mainly anastomotic dehiscence. Methods: Patients who underwent gastrointestinal anastomosis between June 2009 and November 2011 at SSG hospital were considered in the study after taking written informed consent. All these patients were thoroughly investigated pre- operatively. Patients were randomized alternatively either to the stapler group or the hand sewn group. Complications observed in both the groups were noted and managed. Results: The study comprised of 50 patients undergoing 60 gastrointestinal anastomosis. Majority of patients were in the age group of 30-50 years. There was 13.3% anastomotic leak rate in hand sewn group and 3.3% stapler group. Other complications like burst abdomen, electrolyte imbalance, pulmonary complications, cardio-vascular complications, wound infection etc were also noted in few patients. The complications rate was significantly high in hand sewn group which is statistically significant. Death rate was high in hand sewn group but this difference was not significant. Conclusions: There was significant reduction in the incidence of anastomotic complications with use of staplers but death rate showed no difference.