SUTURING OR STAPLING IN GASTROINTESTINAL SURGERY - A PROSPECTIVE RANDOMIZED STUDY

A prospective randomized study of 1004 patients is reported, comparing surgical stapling and manual suturing techniques in the construction of gastrointestinal anastomoses. The incidence of clinical leaks was similar between the two groups (sutured 3.2 per cent, stapled 4.7 per cent; P = 0.22), while for radiological leaks the incidence was significantly higher in the sutured group (12.2 per cent versus 4.1 per cent, P < 0.05). Stapling instruments afforded significantly quicker anastomoses, mean(s.e.m.) 28.1(0.7) versus 14.3(0.5) min (P < 0.001), and quicker operations, 115.5(2.4) versus 103.8(2.2) min (P < 0.001). The two groups were found to be comparable in other respects such as operative mortality, requirements for blood transfusion, incidence of infective complications, recovery of gastrointestinal function and postoperative hospital stay.