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Comparison of Manually Constructed and Stapled Anastomoses in Colorectal Surgery. West of Scotland and Highland Anastomosis Study Group

Overview
Journal Ann Surg
Specialty General Surgery
Date 1995 Feb 1
PMID 7857145
Citations 57
Authors
J G Docherty
J R McGregor
A M Akyol
G D Murray
D J Galloway
Affiliations
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Abstract

Objective: The authors compared both the initial and the long-term outcomes of patients undergoing stapled and sutured colorectal anastomoses.

Summary Background Data: Sutured and stapled large bowel anastomoses are perceived to be equally safe, but concern has been raised about increased rates of tumor recurrence with the use of stapling instruments.

Methods: The outcome of patients with sutured and stapled colorectal anastomoses were compared in a prospective, multicenter, randomized study. Factors affecting long-term outcomes were assessed by both univariate and multivariate analysis.

Results: Seven hundred thirty-two patients were recruited. There was a significant increase in radiologic leakage in the sutured group (14.4% vs. 5.2%, p < 0.05), but there was no difference in clinical anastomotic leak rates, morbidity, or postoperative mortality. Tumor recurrence and cancer-specific mortality were higher in the sutured patients (7.5% and 6.7%, respectively) and in patients with anastomotic leaks.

Conclusions: This study shows that suturing or stapling are equally safe in large bowel surgery. However, it also shows a long-term benefit of stapling in colorectal cancer patients.

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Rectal stenosis after circular mechanical anastomosis; the influence of stapler size.

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The gut barrier as a gatekeeper in colorectal cancer treatment.

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Impact of a circular powered stapler on preventing anastomotic leakage in patients with left-sided colorectal cancer: a retrospective study.

Shibutani M, Fukuoka T, Iseki Y, Kasashima H, Kitayama K, Maeda K BMC Surg. 2023; 23(1):205.

PMID: 37464350 PMC: 10354928. DOI: 10.1186/s12893-023-02104-5.

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