A COMPARATIVE STUDY BETWEEN STAPLED AND HAND SEWN ANASTOMOSIS IN ELECTIVE GASTROINTESTINAL SURGERY IN A TERTIARY CARE HOSPITAL

Abstract

Introduction: Anastomosis is a critical step in gastrointestinal surgery, with hand-sewn and stapled techniques being the main approaches. Hand-sewn anastomosis offers flexibility in complex anatomy, while stapled anastomosis can reduce operative time and standardize technique. Despite widespread use, the superiority of one method over the other remains debated. This study compares stapled and hand-sewn anastomosis in elective gastrointestinal surgery, evaluating operative time, anastomotic leak rates, postoperative complications, and hospital stay. Aims: To compare the outcomes of stapled versus hand-sewn anastomosis in elective gastrointestinal surgery, focusing on operative time, postoperative complications, anastomotic leak rates, and hospital stay. Materials and Methods: This was an institution-based prospective comparative study conducted over 18 months, from March 2021 to August 2022, in the Department of General Surgery at North Bengal Medical College and Hospital, a tertiary care teaching hospital in the Darjeeling district of West Bengal, India. The study population included patients undergoing elective gastrointestinal surgeries in the main operating theater complex under the Department of General Surgery. A total of 100 patients were enrolled, with 50 patients assigned to the stapled anastomosis group and 50 to the hand-sewn anastomosis group. Results: The operative parameters were compared between the stapled and hand-sewn anastomosis groups. The mean operative time in the stapled group was 120 ± 25 minutes, whereas in the hand-sewn group it was 145 ± 30 minutes (P = 0.001), indicating that stapled anastomosis was associated with a significantly shorter operative time. Similarly, the mean anastomosis time was significantly lower in the stapled group, at 15 ± 5 minutes, compared to 30 ± 7 minutes in the hand-sewn group (P < 0.001).In terms of intraoperative blood loss, the stapled group had a mean blood loss of 150 ± 50 ml, compared to 160 ± 60 ml in the hand-sewn group (P = 0.42), showing no statistically significant difference between the two groups Conclusion: Both stapled and hand-sewn anastomoses are safe and effective for elective gastrointestinal surgery. Stapled anastomosis provides reduced operative time and ease of performance, while hand-sewn techniques remain valuable for specific situations requiring flexibility. Selection should be guided by patient factors, anatomical considerations, and resource availability.