Comparison of the outcome after the anastomosis of intestine with mechanical stapler versus hand suturing – A Prospective Observational Study

Introduction: Intestinal anastomosis connects bowel segments with good bloodsupply. Techniques include end-to-end, end-to-side, side-to-end, and side-toside, using hand-sewn or stapled methods. This study compares outcomes ofhand suturing versus mechanical stapling. Methods: We conducted a prospective observational study comparing handsutured and stapled bowel anastomosis outcomes from September 2020 toFebruary 2022 in our Hospital, surgery department. Eighty ethically-approvedpatients were divided into two groups, and data were analyzed using SPSSversion 23 with Chi-square and t-tests. Results: The study involved 80 patients, divided equally between hand suturingand stapler groups. The mean age was 49.5 ± 16.5 years for hand suturing and50.6 ± 14.4 years for staplers. Hand suturing took an average of 42.00 ± 8.7minutes, and stapling took 14.13 ± 4.5 minutes. Surgery duration was 2.72 ± 0.95hours for hand suturing and 2.15 ± 0.62 hours for staplers. Anastomotic leakageoccurred in 11.3% of hand-sutured cases and 3.8% of stapled cases. SSI rateswere 18.8% for hand suturing and 5.0% for staplers. Hospital stay averaged 12.28± 5.3 days for hand suturing and 9.23 ± 3.03 days for staplers. The cost was 23.22± 6.45 thousand for hand suturing and 46.42 ± 15.74 thousand for staplers. Conclusion: Intestinal anastomosis with a stapler is quicker and leads to shorterhospital stays, while hand suturing takes longer and extends hospital stays. Bothmethods have similar leakage and mortality rates. Hand suturing requires skilledoperators and has a steep learning curve, unlike the stapler technique.