Dominic Foo, Jeremy Yip, A Chiu, Wai Lun Law. The University of Hong Kong
Background: Over the past few decades, studies have focused on the efficacy of stapled anastomosis, especially when compared to the hand sewn technique. There were, however, very limited studies focusing on improvement in stapling technique. This study aimed to ascertain whether triple-rowed staples (tri-staples) have any advantage over double-rowed staples.
Method: There were 563 consecutive cases of stapled functional end-to-end ileocolic anastomosis performed in two centers from 2005 to 2015. Data were retrieved from a prospectively kept database. 389 and 174 of these anastomoses were performed with double-rowed (DS) and triple-rowed staples (TS) respectively. 170 cases were chosen from each group by propensity score matching, taking the following into account: age, gender, ASA, co-morbidities, previous cancer and abdominal surgery, serum biochemistry, malignant pathology, perforated or obstructed tumor, stage of the disease, type and approach of surgery. The rate of anastomotic leakage, bleeding, re-operation and 30-day mortality rate was compared.
Results: After prospensity score matching, both groups showed comparable baseline characteristics. The anastomotic leakage rate was 2.4% and 0% (p=0.123), the anastomotic bleeding rate was 1.2% and 0% (p=0.499) and the intra-abdominal collection rate was 3.5% and 1.2% (p=0.283) for DS and TS respectively. The re-operation rate was 5.9% and 1.8% (p=0.048) and 30-day mortality was 0.6% and 1.2% (p=1.000) for DS and TS respectively. The hospital stay was 9.2 ± 15.0 and 7.3 ± 5.3 (p=0.114) for DS and TS respectively.
Conclusion: Triple-rowed staples did not have significant advantage over double-rowed staples in this study.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 78635
Program Number: S044
Presentation Session: Colorectal 1
Presentation Type: Podium