Abstract

Dr. Arijit Bagchi and *Dr. Purujit Choudhury

ABSTRACT

Background: Emergency abdominal surgeries often require bowel anastomosis, with both hand-sewn and stapled techniques being commonly used. The optimal choice of anastomosis method in emergency settings remains debated, particularly in resource-limited environments. Aim: To compare the outcomes of hand-sewn versus stapled anastomosis in emergency abdominal surgeries at a tertiary healthcare centre in Guwahati, Assam. Methods: This prospective comparative observational study included 78 patients undergoing emergency abdominal surgery requiring bowel anastomosis between May 2023 and April 2024. Patients were divided into hand-sewn (n=52) and stapler (n=26) groups. Outcomes assessed included anastomotic leak rates, operative time, hospital stay, complications (Clavien-Dindo classification), and recovery parameters. Results: The stapler group demonstrated significantly shorter mean operative time (172.3 ±39.7 vs 198.4 ±45.6 minutes, p=0.017). While not statistically significant, the stapler group showed trends towards lower anastomotic leak rates (3.8% vs 9.6%, p=0.362), shorter hospital stays (10.4 ±4.8 vs 12.7 ±5.3 days, p=0.064), and faster return to normal bowel function (3.7 ±1.4 vs 4.2 ±1.6 days, p=0.169). Overall complication rates were similar between groups (p=0.583). Conclusion: While both techniques proved safe, stapled anastomosis showed potential advantages in emergency abdominal surgeries, including significantly reduced operative time and favourable trends in postoperative outcomes. These findings suggest that stapled anastomosis may be preferable in certain emergency cases, particularly when shorter operative times are crucial. However, the choice should still consider individual patient factors, surgeon expertise, and resource availability. Larger, randomised studies are needed to confirm these trends.