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[Manual and stapled sutures in digestive surgery: a comparative evaluation].
G Negro1, V Di Blasio, G Arciero
1II Facoltà di Medicina e Chirurgia, Università degli Studi di Napoli.
Il Giornale Di Chirurgia
|April 1, 1992
Summary
For digestive sutures and anastomoses, staplers offer better outcomes in esophageal, rectal, and duodenal procedures. However, hand-sewn techniques are superior for intestinal anastomoses in non-elective surgery, showing lower morbidity and mortality.
Area of Science:
- Gastroenterology
- Surgical Techniques
- Comparative Effectiveness Research
Background:
- Digestive sutures and anastomoses are critical in gastrointestinal surgery.
- Both hand-sewn and mechanical (stapled) techniques are utilized.
- Comparative data on their effectiveness in various surgical scenarios is essential.
Purpose of the Study:
- To retrospectively analyze and compare the outcomes of hand-sewn versus stapled digestive sutures and anastomoses.
- To identify specific anatomical locations and surgical conditions where one technique may be superior.
Main Methods:
- Retrospective analysis of 819 digestive sutures and anastomoses.
- Categorization of procedures into hand-sewn (45.9%) and stapled (54.1%).
- Comparative evaluation of outcomes based on anatomical site and surgical context (elective vs. non-elective).
Main Results:
- Mechanical suturing showed better results for esophageal, rectal anastomoses, and duodenal stump closure.
- For elective intestinal anastomoses, both techniques yielded similar results.
- In non-elective intestinal surgery, hand-sewn sutures demonstrated significantly lower morbidity (10.2% vs. 30.9%) and zero mortality compared to stapled methods.
Conclusions:
- Staplers are recommended for esophageal, rectal, and duodenal anastomoses.
- Hand-sewn techniques are preferred for intestinal anastomoses in non-elective surgical settings due to improved safety profiles.