Introduction: All the temporarily made ileostomies require subsequent closure or reversal. The anastomotic technique may be hand sewn or stapled. We are using skin stapler for gut anastomosis, which is much cheaper than modern stapling devices but equally effective, and comparing the frequency of anastomotic leakage with handsewn technique of bowel anastomosis. The rationale to carry out this study is that if this study concludes in favor of stapled technique over conventional hand sewn technique patients would not only benefit in terms of safer reversal, but also would be benefited from shorter duration of operation. Moreover the local surgeons would gain confidence in adopting recent advancements in gut anastomosis.
Methodology: All procedures were done by skilled forth year surgical trainees under consultant’s supervision. Ileostomy reversals was done via stapling or suturing technique according to patient’s randomization. The patients were then evaluated for signs of anastomotic leakage by consultants at the day of discharge (5th post-operative day) and as an outpatient at 10th (the day of skin stitches / staplers removal) and 20th day after operation.
Results: Nine of 162 (5.6%) patients in the handsewen group and six of 162 (3.7%) in stapler group develop anastomotic leakage within 20 post-operative days after ileostomy reversal (p = 0.428). Hence the alternate hypothesis is rejected and though the number of hand sewn anastomosis leaked i.e. 9 were more than number of leaked stapled anastomosis i.e. 6, this difference is not found to be statistically significant.
Conclusion: Skin staples are easily available, cost effective, the technique employed has a low learning curve and gives comparable results in terms of anastomotic leakage with hand sewn anastomotic technique as well as other modern stapling devices.
