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Evidence summaries

Stapled Versus Handsewn Methods for Ileocolic Anastomoses

Stapled functional end to end ileocolic anastomosis is associated with fewer leaks than handsewn anastomosis. Level of evidence: "A"

A Cochrane review [Abstract] 1 included 7 studies with a total of 1125 subjects. Stapled anastomosis was associated with significantly fewer anastomotic leaks compared with handsewn (S=11/441, HS=42/684, OR 0.48 [0.24, 0.95]). For the sub-group of 825 cancer patients in four studies, stapled anastomosis led to significant fewer anastomotic leaks (S=4/300, HS=35/525, OR 0.28 95% Cl 0.10 to 0.75). In subgroup analysis of non-cancer patients (3 studies, 264 patients) There were no differences for any reported outcomes. All other outcomes: stricture, anastomotic haemorrhage, anastomotic time, re-operation, mortality, intra-abdominal abscess, wound infection and length of stay showed no significant difference.

    References

    • Choy PY, Bissett IP, Docherty JG et al. Stapled versus handsewn methods for ileocolic anastomoses. Cochrane Database Syst Rev 2011;(9):CD004320. [PubMed]

Primary/Secondary Keywords