Stapled Versus Hand-Sewn Anastomosis in colorectal Cancer Surgery: A comparative study
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2018, Vol 17, Issue 10
Abstract
Introduction: There is a doubt about the leakage after colorectal anastomosis despite various intestinal anastomotictechniques. More risk is noticed in distal rectal anastomosis after cancer surgery it poses more risk due to poor colonic vascularity and reduced remaining tissue to nourish the anastomotic site. In terms of sphincter saving, thereby improving quality of life these surgical staplers has provided some procedural advantages and sense of security to surgeons as well as to patients. However, efficacy over conventional handsewn technique is better observed based on the outcome measures of these devices because their cost play role in treatment plan. Our study results might help surgeons to counsel the patients regarding the feasibility in usage of stapler. Objectives: To find out whether stapled anastomosis is safer than hand-sewn anastomosis in colon and rectal cancer surgery. Methods: The prospective observational study was undertaken in the department of general surgery, Kasturba Medical College&hospital during Oct 2015 to July 2017. Total 66 patients were selected. 34 patients underwent ‘Stapled’ and 32 underwent ‘Hand-sewn’ anastomosis. The outcome variables were ‘time required for anastomoses, ‘postoperative hospital stay’ and early and late ‘complications’ in postoperative and follow-up period. Result and observation: The age, sex, co-morbidities did not show any statistical difference between two groups as in the hospital stay (p=.297). The time required for anastomosis showed strongly significant difference (19.61 min and 35.87 min; p=.000) in favor of stapling group. The anastomotic Leakage (p=.608), fever (p=.670) were less in stapled group though they lack statistical power. All others showed almost similar results. Conclusion: Considering user perspective, time requirement stapling technique appear to be safer and superior to handsewn technique though it demands statistical strengthening on large scale study.
Authors and Affiliations
Ravikiran vaddepalli, Naveen PG, Annappa Kudva
Keywords
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- EP ID EP406701
- DOI 10.9790/0853-1710102832.
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