Publication:

Stapler versus handswen in small intestinal anastomosis

Background Intestinal anastomosis dates back to 1000, B.C but it accompanied with high rates of failure, sepsis, wound infection and mortality until the development of suture materials. Lembert described his seromuscular suture technique in 1826. Surgical Stapler was first introduced by Hultl in 1908. The development of modern devices over the past 30 years changes the surgical practice dramatically. The objective of present study is to compare the outcome between Stapler and handswen anastomosis in the small intestine.

Methods This study is a randome controlled study carried on 40 patients divided into two equal groups, 20 patients were treated by handswen suture method (group A) and the other 20 patients operated by stapling technique (group B).

Results In both elective and emergent cases as regard patient operative time, postoperative passing flatus, begin of oral intake, hospital stay duration and postoperative complications it was lower in Stapler (group B) comparing to handswen (group A) and P-value was statistically significant (P 0.05).

Conclusions In both elective and emergent cases the duration of operation, postoperative passing flatus, return of bowel sound, hospitalization days and postoperative complications including (intraoperative bleeding, prolonged ileus >4 days, patient stenosis and wound infection) in Stapler anastomosis it was lower comparing to handswen anastomosis and P-value was statistically significant (P 0.05).