OUTCOME OF STAPLED VERSUS HAND SEWN INTESTINAL ANASTOMOSIS: A COMPARATIVE STUDY

Dr. Abdullah Al Mamun*, Professor A. Z. M Mostaque Hossain, Dr. Sumon Kumar Sen, Dr. Salina Akter, Dr. Md. Mahmudul Hasan and Dr. Ashik Mahmud

ABSTRACT

Background: Intestinal anastomosis is done in various ways and outcomes depends upon the techniques. There are no well-established data or information regarding comparison between traditional hand sewn and stapled anastomosis. The aim of this study is to measure the outcome of these two different surgical approaches. It will be helpful to standardize the most effective surgical approach to do intestinal anastomosis. Methods: This is an observational type of cross-sectional study which was held in the Department of Surgery, Dhaka Medical College Hospital, Dhaka. Study period was six months. Patients who underwent either stapling or hand sewing routine intestinal anastomosis within the study period between 20-60 years of age, irrespective of sex were included in this study.50 patients were randomly allocated into two groups of 25. Result: Mean operation time in stapled group was 92.88(±11.28) mins and 102.60(±15.84) mins in Hand sewn group(p<0.01). Mean anastomotic time in stapled group was16.16(±2.06) mins and 25.12(±3.98) mins in Hand sewn group(p<0.01). Mean post operative hospital stays in both groups were quiet similar. Post operative complications were- fever: in stapled group 2(8%) and Hand sewn06(24%), wound infection: in stapled group 03(12%) and in Hand sewn group 04(16%), ileus/intestinal obstruction: in Stapled group 01(4%) and in Hand sewn 02(8%), anastomotic failure: in stapled group was 1(4%) and in Hand sewn group 02(8%). Conclusion: Stapling technique significantly reduce the time for anastomotic procedure. With reduce operating time and less tissue trauma due to less tissue handling, there is early restoration of gastrointestinal function, early resumption of oral feeding and early recovery.

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