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LETTER TO EDITOR
Year : 2016  |  Volume : 6  |  Issue : 3  |  Page : 190

Re: Surgical outcome of stapled and handsewn anastomosis in lower gastrointestinal malignancies: A prospective study


Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA

Date of Web Publication17-Mar-2017

Correspondence Address:
Kenji Okumura
Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX
USA
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2278-9596.202372

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How to cite this article:
Okumura K. Re: Surgical outcome of stapled and handsewn anastomosis in lower gastrointestinal malignancies: A prospective study. Arch Int Surg 2016;6:190

How to cite this URL:
Okumura K. Re: Surgical outcome of stapled and handsewn anastomosis in lower gastrointestinal malignancies: A prospective study. Arch Int Surg [serial online] 2016 [cited 2019 Dec 12];6:190. Available from: http://www.archintsurg.org/text.asp?2016/6/3/190/202372

Sir,

I read with interest the article by Khan et al.[1] published in the July 2016 issue. Comparing stapled and handsewn colorectal anastomosis has been one of the longstanding debated topic. There are several articles comparing the techniques. Although some articles support stapler techniques, from the previous review, the evidence found was insufficient to demonstrate superiority of the stapler to handsewn anastomosis, independent of the level of anastomosis.[2] In reality, laparoscopic surgery has gained a significant role in colorectal surgery and the chances of handsewn colorectal anastomosis has been dramatically reduced.[3] Considering these situations, this study is very interesting, however, I think there are several limitations of this study. First, the number of patients are too small to discuss the incidences of complications, i.e., anastomotic leak and infection complications. Second, there is no documentation regarding the criteria to start oral feeding, and caregivers might have a bias because this study is not a double-blinded study and caregivers could know the way of anastomosis and could change the postoperative management.

I personally support mentioning the healthcare cost and operation time to suture, however, they should be evaluated using multifactorial approaches.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

 
  References Top

1.
Khan AQ, Awan N, Dar WR, Mehmood M, Latief M, Sofi N, et al. Surgical outcome of stapled and handsewn anastomosis in lower gastrointestinal malignancies: A prospective study. Arch Int Surg 2016;6:1-6.  Back to cited text no. 1
  [Full text]  
2.
Neutzling CB, Lustosa SAS, Proenca IM, da Silva EMK, Matos D. Stapled versus handsewn methods for colorectal anastomosis surgery. Cochrane Database Syst Rev 2012;15:CD003144.  Back to cited text no. 2
    
3.
Pascual M, Salvans S, Pera M. Laparoscopic colorectal surgery: Current status and implementation of the latest technological innovations. World J Gastroenterol 2016;22:704-17.  Back to cited text no. 3
    




 

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