Stapled versus hand sewn anastomoses in patients with small bowel injury: A changing perspective

J. D. Witzke, J. J. Kraatz, J. M. Morken, A. L. Ney, M. A. West, J. M. Van Camp, R. T. Zera, J. L. Rodriguez, Gregory Jurkovich, D. Feliciano, P. A. Taheri, J. G. Hinsdale, H. J. Sugerman, D. Demetriades, C. J. Hauser, J. J. Kraatz

Research output: Contribution to journalArticlepeer-review

28 Scopus citations

Abstract

Introduction: Recent studies indicate that trauma patients with hollow viscus injuries requiring anastomosis who are managed with stapling have a higher rate of complications than do those in whom a hand-Sewn anastomosis is used. We undertook this study to determine whether this finding applied to patients with small bowel trauma at our institution. Methods: Records of patients with small bowel injuries were retrospectively reviewed. Demographics, severity of injury, injury management, and outcome data were collected. Results: Patients who had their small bowel injuries managed by hand-Sewn repair versus resection and stapled anastomosis demonstrated a nonsignificant decrease in overall complication rate (35% vs. 44%) and rate of intra-abdominal complication (10% vs. 18%). Yet the rate of intra-abdominal abscess formation was significantly lower with hand-sewn repair than with resection and stapled anastomosis (4% vs. 13%). However, when handsewn primary repairs were excluded from the analysis and injuries that required resection and either stapled or hand-sewn anastomosis were compared, there was a similar overall complication rate (41% vs. 41%) and rate of intra-abdominal complications (17% vs. 21%). Conclusion: The rate of intra-abdominal complications did not differ significantly between patients requiring small bowel resection and reanastomosis managed by either a stapled or hand-sewn technique. In our experience, surgical stapling devices appear to be safe for use in repairing traumatic small bowel injury.

Original languageEnglish (US)
Pages (from-to)660-666
Number of pages7
JournalJournal of Trauma - Injury, Infection and Critical Care
Volume49
Issue number4
DOIs
StatePublished - Jan 1 2000
Externally publishedYes

ASJC Scopus subject areas

  • Surgery
  • Critical Care and Intensive Care Medicine

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