Comparison of Hand-Sewn and Stapled Anastomoses in GI Surgeries Based on Clinical Practice at Krishna Hospital, Karad

Background There is a lack of studies comparing stapled suturing and hand-sewn suturing in GI surgeries in tier 2 towns of India. Methods Data were retrospectively collected from 499 patients who underwent GI surgeries from January 2016 to December 2016. The patients were divided into two groups according to the method of digestive tract reconstruction 296 patients received stapled suturing and 203 patients received hand-sewn suturing. The operation time, postoperative hospital stay, postoperative recovery and complications of the patients were evaluated and compared between the two groups. Results The stapling procedure took shorter operative time compared to the hand-sewn procedure for gastric carcinoma, colorectal cancer and esophageal carcinoma (P less than 0.05). There was no significant difference between the two groups in postoperative hospital stay (P greater than 0.05). Patients receiving hand sewn suturing also showed shorter recovery for gastric cancer, colorectal cancer, and shorter time to recovery of normal gastrocolorectal motility compared with patients in the stapled suturing group (P less than 0.05) in rural areas. However, there was no difference between the two groups in terms of normal time to commencing liquid diet for esophageal cancer patients (P greater than 0.05). We also found that the stapled procedure showed a lower incidence of anastomotic leakage, anastomotic hemorrhage and stump leakage in treating colorectal cancer or gastric carcinoma compared with the hand-sewn procedure (P less than 0.05). However the cost of staplers was too high for patients in tier 2 towns making in unaffordable for most of them. Conclusions Application of the stapler in GI surgeries demonstrated no better effects on patients in terms of surgical operation time, recovery time to normal functions, and occurrence of complications compared to hand-sewn anastomosis, especially in gastric carcinoma and colorectal cancer.