Mechanical vs. Manual Anastomosis in Colorectal Cancer Surgery: A Comparative Analysis

Abstract

Background: colorectal cancer is a common and serious condition, with surgical resection being the primary treatment for localized cases. Anastomotic dehiscence (AD) remains a significant postoperative complication, and anastomoses are typically created using either manual suturing or mechanical stapling, each with specific benefits and challenge. Material and Methods: this retrospective study analyzed outcomes in 100 rectal cancer patients who underwent surgical resection, with anastomoses performed via manual suturing (n=50) or mechanical stapling (n=50). Primary outcomes included fistula rates, postoperative complications, and recovery metrics. Secondary outcomes focused on operative time, hospital stay and quality of life. Results: mechanical anastomosis reduced procedure time (15 +- 5 minutes vs. 30 +- 5 minutes; p 0.01) and improved quality of life at 12 months (HQI: 87 vs. 75; p 0.01). The incidence of fistulas was higher in patients with manual suturing compared to mechanical suturing, but without significant differences (12% vs. 22%; p = 0.29). Mechanical anastomosis shortened the hospitalization period (12.66 vs. 13.58 days; but manual suturing allowed for faster recovery of intestinal transit (82% vs. 76%). Conclusions: mechanical anastomosis is more efficient, but manual anastomosis remains valuable in complex cases. Technique selection should be tailored to individual patient needs and surgical conditions.

Keywords: anastomoticdehiscence; anastomoticfistula; colorectalcancer; rectalcancer.