Xiaocheng Zhu, Chao Li, Libin Yao, Hui Wang, Linsen Shi, Song Meng. Department of General Surgery, the Affiliated Hospital of Xuzhou Medical College Jiangsu China
Objective: To establish an easy, safe and cost-saving intestinal anastomotic method. Methods: Between January, 2014 and August, 2015, a total of 330 patients with gastric cancer underwent surgery in the Department of General Surgery of Xuzhou Medical College Affiliated Hospital were divided into two groups; treatment group(80) using a new hand-sewn anastomoses and control group(250) using stapled anastomoses. Briefly, a new hand-sewn anastomoses of continuous suture without inversion performed in the whole layer of intestinal wall for the first layer, the edge was about 5mm and the stitch spacing was about 6mm, then the continuous suture continued performed only in the seromuscular layer of intestinal wall for the second layer, the edge and the stitch spacing was the same to the first layer. 250 patients in control group underwent intestinal stapled anastomoses. Surgical anastomotic time and cost, postoperative anastomotic bleeding, leakage and stricture were recorded and analyzed. Results: The surgical anastomotic time using the new method was relative short compared with the control group (8±1.6min vs 10±2.8min) and the cost of anastomosis using the new method were significantly low compared to the control group (30±6.8$ vs 1000±106.2$). The new method exhibited a lower anastomotic bleeding (0/80 vs 2/250), anastomotic leakage (0/80 vs 1/250) ,but similar anastomotic stricture(0/80 vs 0/250). Conclusions: Our results suggested that the new hand-sewn intestinal anastomoses is a safe, easy to learn, cost-saving and time-saving method , also avoid some drawbacks of the stapled anastomoses.