Outcomes of Bowel Anastomosis Using Stapled Versus Hand-Sewn Techniques in Colorectal Surgery

Background: The technique of anastomosis is also a determining factor that will impact surgical outcome in the case of colorectal operations. Although the utilization of mechanical staplers has been widely adopted, there have been controversies on the difference in the superiority of using this mode of stapling to the traditional hand-sewn technique, especially in the resources limited environments. Objective: To compare clinical outcomes, complication rates, and operative parameters between stapled and hand-sewn bowel anastomosis in patients undergoing colorectal surgery. Methodology: This was a prospective comparative study of a period of twelve months beginning in January 2024 until January 2025 at Dara Welfare Hospital Kohat. Total 72 patients who were having elective colorectal resection were recruited using consecutive sampling and were split into stapled (n=36) and hand-sewn (n=36) categories. The main outcomes that were evaluated were anastomotic leakage, operation time and postoperative complications. The analysis of data was done using the chi-square test and independent t-test with the p value of less than 0.05. Results: Stapled anastomosis demonstrated significantly shorter operative time (78.4±12.3 vs 104.7±15.8 minutes, p<0.001) and reduced hospital stay (6.8±1.4 vs 8.3±2.1 days, p=0.001). Anastomotic leak rates were comparable between groups (5.6% vs 8.3%, p=0.647). Stapled technique showed lower overall complication rates (16.7% vs 30.6%, p=0.042) and earlier return of bowel function (2.3±0.6 vs 3.1±0.8 days, p<0.001). Conclusion: Stapled anastomosis offers significant advantages in operative efficiency and postoperative recovery without compromising anastomotic integrity.