IJSR - International Journal of Scientific Research

Venkatarami Reddy Vutukuru; Sivarama Krishna Gavini; Chandramaliteeswaran C; Dinakar Reddy A; Dr. Sarala Settipalli

Volume : VI, Issue : XII, December - 2017

PARTIAL STAPLED VERSUS TOTAL STAPLED ILEOCOLIC ANASTOMOSIS IN RIGHT HEMICOLECTOMY: A RANDOMIZED CONTROL STUDY

Venkatarami Reddy Vutukuru, Sivarama Krishna Gavini, Chandramaliteeswaran C, Dinakar Reddy A, Dr. Sarala Settipalli

Abstract :

Introduction: Functional end to end anastomosis (FEAA) is a commonly used anastomotic technique using staplers in right hemicolectomy (RH). It can be done in two ways either partially stapled or totally stapled technique. Our study aims at compå the outcomes between two techniques of performing FEAA.

Materials & Methods: All patients who were planned for RH during Jan 2011– Dec 2014 were included. After mobilising right colon, they were randomized to either partially stapled (transecting ileum and transverse colon with linear stapler and hand sewn side to side anastomosis) (group A) or a standard totally stapled anastomosis (group B). Outcomes were compared between two groups in terms of operative time, blood loss, resumption of orals, anastomotic leak, surgical site infection and mortality. A p value of <0.05 was considered significant.

Results: 104 patients were randomized. 49 underwent partial and 55 underwent total stapled anastomosis. Demographic characteristics, nutritional status, BMI, pathology, emergency/elective surgery were comparable. Operative time was significantly less in total stapled group (123 vs. 94 mins; p<0.0001). Resumption of orals were earlier in total stapled group (4.25 vs. 3.5 days; p<0.05). Anastomotic leak, surgical site infection and mortality were similar. Mean Hospital stay was less in total stapled group (7.8 vs. 6.4 days, p<0.01).

Conclusion: Functional end to end anastomosis (FEEA) using Total stapled anastomosis is a safe anastomotic technique both in elective and emergency setting with shorter operative time, early oral resumption and reduced hospital stay.