[Costs and benefits of mechanical sutures in esophageal surgery]

The cost/benefit ratio of mechanical sutures is a controversial issue. Aim of this work was to compare the cost of esophago-visceral anastomoses performed with staplers versus the cost of conventional anastomoses. Not only the cost of the material, but also the economical impact of the hospital stay and operative complications was evaluated. Results show a statistically significant decrease of morbidity in patients treated with mechanical sutures (3.7% vs 18.8%, p = 0.0001). The overall cost of a single mechanical suture was markedly lower than that of a single manual suture (934.000 vs 2,209.000 Italian lira). We conclude that a significant decrease of hospital cost can be expected using mechanical sutures. It has to be noted, however, that in order to achieve such results, an adequate surgical training with staplers is mandatory.