Meta Analysis of Stapled Vs Hand-Sewn Anastomosis in Gastrointestinal Surgery

Author(s): Falah Munawar, Shaikh Salman Khaled AlKhalifa, Zakariya Abdalsalam AlTraiki, Ahmed Alfatih Sirelkhatim Fadul, Mohamed Gamal Abdelrahim Abdalla, Hussein Khalid Mamdooh, Shijas Shanavas, Amina Hameedh Mahamood, Ria Pillai, Muhammad Salman Arif

As gastrointestinal surgical techniques have advanced, stapled anastomosis has gained popularity due to its claims of easier technical implementation and shorter operating times. The relative safety and efficacy of stapled versus conventional hand-sewn intestinal anastomosis are still being investigated, particularly in light of postoperative leak rates and complications. Comparing stapled and hand-sewn anastomoses across a variety of elective gastrointestinal procedures performed on various age groups was the aim of this meta-analysis. Nine clinical studies, including prospective cohort studies, retrospective comparative analyses, and randomized controlled trials (RCTs), published between 2013 and 2024 were systematically analyzed. Three studies with explicitly stated anastomotic leak incident numbers were used for the pooled meta-analysis [1], [2], [3]. The pooled odds ratio (OR) for leak rates favored stapled anastomosis with a moderate but statistically significant decrease in leaks (OR of 0.88, 95% CI: 0.79–0.99). Low heterogeneity (I2 = 0%) indicates that findings from various studies are in agreement. Additional research has confirmed findings of operative efficiency, postoperative recovery, and safety, especially in complex cases and pediatric surgery [4], [5], [6], [7], [8], [9]. Overall, stapled anastomosis significantly improved operational efficiency and showed a slight improvement in leak reduction without increasing the risk of complications.