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Related Concept Videos

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Related Experiment Video

Updated: May 29, 2026

An Ivor Lewis Esophagectomy Designed to Minimize Anastomotic Complications and Optimize Conduit Function
09:40

An Ivor Lewis Esophagectomy Designed to Minimize Anastomotic Complications and Optimize Conduit Function

Published on: April 17, 2020

Stapled versus handsewn methods for ileocolic anastomoses.

Pui Yee Grace Choy1, Ian P Bissett, James G Docherty

  • 1Surgery, University of Auckland, Auckland, New Zealand.

The Cochrane Database of Systematic Reviews
|September 9, 2011
PubMed
Summary

Stapled ileocolic anastomosis significantly reduces anastomotic leaks compared to handsewn techniques, particularly in right-sided colon cancer surgery. This finding updates previous reviews on surgical outcomes.

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The C-seal: A Biofragmentable Drain Protecting the Stapled Colorectal Anastomosis from Leakage
07:51

The C-seal: A Biofragmentable Drain Protecting the Stapled Colorectal Anastomosis from Leakage

Published on: November 4, 2010

Area of Science:

  • Surgical Gastroenterology
  • Colorectal Surgery
  • Evidence-Based Medicine

Background:

  • Ileocolic anastomoses are frequently performed for right-sided colon cancer and Crohn's disease.
  • Surgical techniques include linear cutter staplers and handsewn (suturing) methods.
  • Previous trials showed no significant difference in complication rates, lacking statistical power.

Purpose of the Study:

  • To compare the outcomes of stapled versus handsewn ileocolic anastomoses.
  • To test the hypothesis that stapling reduces complications, specifically anastomotic leaks.

Main Methods:

  • Systematic review and meta-analysis of randomized controlled trials (RCTs) from 1970 to 2010.
  • Searched major databases (MEDLINE, EMBASE, Cochrane) and handsearched surgical society abstracts.
  • Included RCTs comparing linear cutter staplers with suturing techniques in adults; subgroup analyses for cancer and inflammatory bowel disease indications.

Main Results:

  • Seven trials with 1125 participants (441 stapled, 684 handsewn) were included.
  • Stapled anastomosis showed significantly fewer anastomotic leaks (OR 0.48 [0.24, 0.95], p=0.03).
  • In cancer patients (825 participants), stapled anastomosis significantly reduced leaks (OR 0.28 [0.10, 0.75], p=0.01); no difference in non-cancer patients.

Conclusions:

  • Stapled functional end-to-end ileocolic anastomosis is associated with a lower rate of anastomotic leaks compared to handsewn techniques.
  • The stapling technique offers a significant advantage in reducing leaks, especially in oncological resections.