Outcomes Assessment between Hand Sewn and Stapled Intestinal Anastomosis
Zubair Ahmad Yousfani *
Department of Surgery, Liaquat University of Medical and Health Sciences, Jamshoro, Hyderabad, Pakistan.
Khenpal Das
Department of Surgery, Liaquat University of Medical and Health Sciences, Jamshoro, Hyderabad, Pakistan.
Jabeen Atta
Department of Obstetrics & Gynecology, Bilawal medical college for Boyes LUMHS Jamshoro, Pakistan.
Ghullamullah Rind
Department of Surgery, Liaquat University of Medical and Health Sciences, Jamshoro, Hyderabad, Pakistan.
Moomal Zoya
Accident and Emergency Department LNH Karachi, Pakistan.
Shanti Devi
Obstetrics & Gynecology, Liaquat University of Medical and Health Sciences, Jamshoro, Hyderabad, Pakistan.
*Author to whom correspondence should be addressed.
Abstract
Objective: This study was conducted at the Department of Surgery of Liaquat University of Medical & Health Sciences, Jamshoro, Sindh, Pakistan for comparing the effectiveness of both methods: hand sewn and stapled intestinal anastomosis and to find a better comparatively to be more efficient.
Methods: A total of 70 patients were encompassed who underwent intestinal anastomoses from proximal jejunum to 2/3rd of proximal distal rectum. All patients were assigned to two different groups A and B each encompassing of 35 cases. In group A, the single layer continuous and in group B single layer patients intervallic serosubmucosal anastomosis was made by implementing the stitches approximately 6 mm at a distance integrating around 5.5 mm of the gut in its stretched direction axis evading individual mucosa. The patients were observed post operatively for anastomotic fiasco such as leakage.
Results: Fourteen (14) out of 35 (2.5%) patients in group A developed anastomotic leakage . In group B, the interrupted serosubmucosal anastomoses were made in 26 patients in emergency and remaining were operated schedule wise. Five (7%) patients exhibited anastomotic leakage in group B. In group A, the continuous leakage in serousubmucosal anastomosis was 2.5% while in group B interrupted serousubmucosal anastomosis was 7%.
Conclusion: It has observed in past studies that single layer interrupted stitches leakage is higher as compared to continuous. It is clear that anastomotic failure in group A is greater than group B but it not considerably substantial and hence both are remarkably efficient.
Keywords: Hand sewn, Stapled Intestinal Anastomosis