A Comparative Study of The Clinical Outcomes Using Conventional Manual Staplers and Circular Powered Staplers in Patients Undergoing Left Sided Colorectal Anastomosis

Abstract

Aim: The aim of our study was to assess safety and efficacy of powered circular staplers for colorectal anastomosis and its comparison with conventional (manual staplers). Method: It’s a single institute, single surgeon based retrospective study to compare powered staplers with manual for the patient’s undergoing anastomosis in colorectal surgery. We assessed the two techniques on the basis of type of surgery, technical problems, intraoperative leak, post-operative leak, blood transfusion, post-operative complication rates, adverse events, additional use of analgesics, antibiotics and readmission rates. SPSS version 20 was used to perform the statistical analysis. Result: Study consisted of forty- eight patients who underwent surgery for colorectal disease. Mean operating time was same for both the groups (3.33 hours). One post-operative leak was observed in manual stapler anastomosis. Four patients had complications including anastomotic leak, anastomotic stricture, wound infection and perianal pain in our study, amongst them three patients underwent manual anastomosis while one patient underwent powered anastomosis. One patient in each arm required readmission. Three patients who underwent powered stapler anastomosis required higher analgesics and higher antibiotics as compared to none in manual, however it was not statistically significant. The mean pain score for patient in powered stapler and manual stapler was 2.96 and 2.92 respectively(p<0.851), while mean length of stay was 7.04 for powered and 6.1 for manual stapler(p<0.08). Conclusion: In our preliminary study, powered stapler was safe and efficacious without any added complications and adverse events. We observed comparable intraoperative and higher trends of post-operative complication rates in manual stapler group.