Ileocolonic anastomosis after right hemicolectomy for carcinoma: stapled or hand-sewn?

✍ Scribed by M. Kracht; J. -M. Hay; P. -L. Fagniez; A. Fingerhut

• Book ID: 104730548
• Publisher: Springer
• Year: 1993
• Tongue: English
• Weight: 549 KB
• Volume: 8
• Category: Article
• ISSN: 0179-1958
• DOI: 10.1007/bf00341273

✦ Synopsis

440 patients were prospectively enrolled in a randomized, multicenter trial to compare 4 types of manual (84 interrupted end-to-end, 77 continuous end-to-end, 82 interrupted end-to-side, and 91 continuous end-to-side) (polyglycolic derived suture) and 1 type of stapled (106 side-to-side with GIA+TA devices) ileocolonic anastomosis after right hemicolectomy for carcinoma. The trial was designed according to Schwartz' pragmatic formulation. All 5 groups were well-matched, except for a lower rate of intraoperative sepsis in the stapled group (P < 0.02). The main end point was anastomotic leakage detected clinically or by routine sodium diatrizoate enema on the 8-10th postoperative day. Results showed that stapled ileocolonic anastomosis was associated with less anastomotic leakages (2.8%) than all the other techniques combined (8.3%). In spite of the fact that staples are approximately ten times more expensive, our results suggest performing side-to-side (GIA+TA) mechanical anastomosis after right resection for carcinoma.