~ 129 ~ International Journal of Surgery Science 2024; 8(1): 129-135 E-ISSN: 2616-3470 P-ISSN: 2616-3462 © Surgery Science https://www.surgeryscience.com 2024; 8(1): 129-135 Received: 16-12-2023 Accepted: 28-01-2024 AKM Touhidul Islam Resident Surgeon (Surgery), Enam Medical College Hospital, Savar, Bangladesh Mahbuba Akhter Indoor Medical Officer, Casualty Block, Dhaka Medical College Hospital, Dhaka, Bangladesh Md. Atiqur Rahman Bhuiyan Assistant registrar, Department of Surgery, Sir Salimullah Medical College Mitford Hospital, Mitford, Dhaka, Bangladesh Biplob Chandra Bandha Assistant registrar, Department of Surgery, Sir Salimullah Medical College Mitford Hospital, Mitford, Dhaka, Bangladesh Anup Kumar Sarkar Medical Officer, OSD (DGHS- On Deputation), Attached: National Heart Foundation Hospital and Research Institute, Dhaka, Bangladesh HM Mamun Resident surgeon, District Hospital, Chapainobabgabj, Bangladesh Md. Khurshid Alam Registrar (Surgery), Rajshahi Medical College Hospital, Rajshahi, Bangladesh Md. Zohurul Islam Registrar, Surgery, Rajshqhi Medical College Hospital, Rajshahi, Bangladesh Md. Saleh Medical Officer, Surgery, Central Police Hospital, Rajarbag, Dhaka, Bangladesh Mohammad Abdul Mannan Junior Consultant (General Surgery), Upazila Health Complex, Moheshkhali. Cox’s Bazar, Bangladesh Raisul Islam Resident surgeon (Surgery), Enam Medical College Hospital, Savar, Bangladesh Corresponding Author: AKM Touhidul Islam Resident Surgeon (Surgery), Enam Medical College Hospital, Savar, Bangladesh Outcome of gastrointestinal anastomosis following the use of stapling device and hand-sewn method: A comparative study AKM Touhidul Islam, Mahbuba Akhter, Md. Atiqur Rahman Bhuiyan, Biplob Chandra Bandha, Anup Kumar Sarkar, HM Mamun, Md. Khurshid Alam, Md. Zohurul Islam, Md. Saleh, Mohammad Abdul Mannan and Raisul Islam DOI: https://doi.org/10.33545/surgery.2024.v8.i1b.1061 Abstract Background: Intestinal anastomosis is one of the most commonly performed surgical procedures for benign or malignant gastrointestinal conditions. The choice for anastomosis between a stapling device and a hand-sewn approach relies on the surgeon’s preference and also their level of surgical experience. Failure of intestinal anastomosis leads to anastomotic leakage; regarded one of the most commonly feared complication in surgical practice & is more serious and life threatening for malignant cases. This study was conducted with the objective of comparing the outcomes of stapling device and hand-sewn anastomosis of the gastrointestinal tract. Aims: To assess and compare the clinical outcome of the patient in any elective gastrointestinal surgery using a stapler device vs. the hand-sewn method of anastomoses. Methods: This prospective comparative study was conducted for 12 months at the Department of Surgery, Sir Salimullah Medical College Mitford Hospital, Dhaka. 50 subjects underwent elective surgery, with one group (n = 25) undergoing stapling and the other group (n = 25) undergoing hand-sewn anastomosis. Results: The mean age was 44.08±11.81 yrs. and 38.04±15.55 yrs. in the stapled group and hand-sewn group, respectively. The mean duration of surgery was 149.4±44.1 minutes in the stapled group and 183.6±60.1 minutes in the hand sewn group. Mean duration of surgery was significantly lower in the stapled group compared to the hand sewn group (p = 0.026). Three (12.0%) patients had an anastomotic leak in the stapled group and two (8.0%) individuals in the hand-sewn anastomosis. No significant difference in postoperative leakage between the two groups (p=0.635). The postoperative complications— fever was significantly higher in the hand-sewn group compared to the stapler anastomosis group (p<0.05). The mean VAS score for pain showed a significant difference on day 3 and day 5. The mean hospital stay was 13.72±2.54 days in the stapler group and 15.76±1.98 days in the hand-sewn group. Mean hospital stay was significantly reduced in the stapler group compared to the hand sewn group (p=0.003). The mean drain indwelling time was 8.64±1.04 days in the stapler group and 8.04±1.34 days in the hand-sewn group, which was not statistically significant between groups (p=0.083). Conclusion: Stapling technique appears to be safer and superior to hand-sewing technique when operating time, hospital stay and fever are taken into account. There is no significant difference in anastomotic leak cases between the two techniques. Stapler anastomosis is a new surgical innovation that can be performed successfully and safely. Keywords: Anastomotic leakage, stapling device, hand-sewn method, gastrointestinal Introduction In gastrointestinal surgery, intestinal resection and anastomosis are the most frequently performed surgical procedures in the elective or emergency setting for benign or malignant conditions. The fate of an anastomosis depends on the site of anastomosis, bowel caliber, and the nature of the underlying disease. The choice for anastomosis between a stapling device and a hand-sewing approach relies on the surgeon’s preference and level of surgical experience [1] . Failure of intestinal anastomosis leads to anastomotic leakage, regarded as one of the most commonly feared complications in surgical practice, and it's more serious and life- threatening for malignant cases, leading to increased morbidity and mortality. The worldwide anastomotic leakage rate is 7.5% and it is more in colonic cancer patients [2] .