Mechanical vs. Manual Anastomosis in Colorectal Cancer Surgery: A Comparative Analysis
Silviu Stefan Marginean, Adrian Radu Petru, Dragos Garofil, Vlad Paic, Razvan Daniel Chivu, Dan Cartu, Anca Tigora, Mihai Zurzu, Mircea Bratucu, Raluca Gabriela Ioan, Florian Popa, Traean Burcos, Valeriu Surlin, Victor Strambu, Irina Ruxandra StrambuOriginal article, no. 6, 2024
Article DOI: 10.21614/chirurgia.3073
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.
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: colorectal cancer, anastomotic dehiscence, anastomotic fistula, rectal cancer