An Effective New Intestinal Anastomosis Method

Med Sci Monit. 2016 Nov 26:22:4570-4576. doi: 10.12659/msm.902000.

Abstract

BACKGROUND This study aimed to establish an easy, safe, and cost-saving intestinal anastomotic method. MATERIAL AND METHODS Between January 2014 and February 2016, a total of 150 patients with gastric cancer who underwent surgery in the Department of General Surgery of Xuzhou Medical University Affiliated Hospital were divided into 2 groups: the treatment group (80) using new hand-sewn anastomoses, and the control group (70) using stapled anastomoses. Briefly, a new hand-sewn anastomosis of continuous suture without inversion was performed, with the first layer encompassing the entire layer of the intestinal wall. The edge was about 5 mm, and the stitch spacing was about 6 mm. Continuous suturing was performed only in the seromuscular layer of intestinal wall for the second layer, with the same edge and stitch spacing as the first layer. All 70 patients in the control group underwent intestinal stapled anastomoses. Surgical anastomotic time and cost, postoperative anastomotic bleeding, leakage, and stricture were recorded and analyzed. RESULTS The surgical anastomotic time using the new method was relatively short compared with the control group (8±1.6 min vs. 9±2.8 min), and the cost of anastomosis using the new method was significantly lower compared to the control group ($30±6.8 vs. $1000±106.2). The new method exhibited lower anastomotic bleeding (0/80 vs. 2/70) and anastomotic leakage (0/80 vs. 1/70), but similar anastomotic stricture (0/80 vs. 0/70). CONCLUSIONS Our results suggest the new hand-sewn intestinal anastomosis is a safe, easy-to-learn, cost-saving, and time-saving method that also avoids some of the drawbacks of the stapled anastomoses.

MeSH terms

  • Anastomosis, Surgical / adverse effects
  • Anastomosis, Surgical / economics
  • Anastomosis, Surgical / methods*
  • Case-Control Studies
  • Demography
  • Female
  • Humans
  • Intestines / surgery*
  • Male
  • Middle Aged
  • Perioperative Care
  • Postoperative Complications / etiology
  • Time Factors