[Comparative analysis of sutured and stapled colorectal anastomoses]

Abstract

In the period of 1987-1993 at the Clinic of General and Vascular Surgery, Military Medical Academy, 364 colorectal anastomoses were performed; the group I was composed of 167 patients with sutured anastomoses, and 197 patients with stapled anastomoses were in the group II. More than half of patients were over 60, and ratio between males and females was 2:1. The reason for resection in almost 90% of the patients was adenocarcinoma of the rectum of which in 40% of the patients the process advanced up to stages C and D by Dukes. Pathologic process in the group I was localized in the lower two thirds of the rectum in 24.6% of the patients, while the percentage in the group II was tripled--76.1%. Surgical wound complications were most frequent in both groups (14.3%:9.6%), and complications associated with anastomosis were less frequent in the stapler group. Clinically clear anastomosis dehiscence appeared in 11.4% of the group I and in 10.7% of the group II. Total mortality was 3.3% (Group I 3.6%, group II 3.0%). By comparative analysis of early complications after resection of the rectum with sutured or stapled colorectal anastomosis, it is concluded that the introduction of staplers in colorectal surgery facilitated the easier accomplishment of larger number of low-lying colorectal or coloanal anastomoses, which are safer and followed by fewer complications, and with equal oncological disease control.