COMPARISON OF OUTCOMES OF STAPLED VERSUS CONVENTIONAL ANASTOMOSIS IN PATIENTS UNDERGOING ILEOSTOMY REVERSAL SURGERY

¹Dr. Ghazanfar Hussain Surahio, ²Dr. Zubair Ahmed Yousfani, ³Dr. Khenpal Das, ⁴Dr. Muhammad Amin Memon, ⁵Dr. Iqra Qaimkhani, ⁶Dr. Madni Memon, ⁷Dr. Maria Zeb, ⁸Dr. Mohsin Ali Nangraj, ⁹Dr. Qurat ul Ain

¹LUMHS Jamshoro, FCPS Postgraduate Resident, MBBS, FCPS

²LUMHS Jamshoro,  Associate Professor Surgery, MBBS, FCPS (Surgery)

³LUMHS Jamshoro,  Associate Professor Surgery, MBBS, FCPS (Surgery)

⁴LUMHS Jamshoro, FCPS Postgraduate Resident, MBBS, FCPS

⁵LUMHS Jamshoro, FCPS Postgraduate Resident, MBBS, FCPS

⁶LUMHS Jamshoro, FCPS Postgraduate Resident, MBBS, FCPS

⁷LUMHS Jamshoro, FCPS Postgraduate Resident, MBBS, FCPS

⁸LUMHS Jamshoro, FCPS Postgraduate Resident, MBBS, FCPS

⁹LUMHS Jamshoro, FCPS Postgraduate Resident, MBBS, FCPS

ABSTRACT

OBJECTIVE

To compare the outcomes of stapled versus conventional anastomosis in patients undergoing ileostomy reversal.

METHODOLOGY

This investigation followed a randomized controlled trial design and was conducted in the Department of General Surgery, Liaquat University of Medical and Health Sciences (LUMHS) from March 2025 to September 2025. A total of 128 adults (18–60 years) undergoing elective ileostomy reversal were enrolled. Inclusion required defined clinical and radiological criteria, while patients with parastomal hernia, BMI ≥35, or chronic illness were excluded. Participants were randomized to undergo either stapled or hand-sewn anastomosis. Data were meticulously recorded and analyzed using SPSS Version 26, with the Chi-square test employed to determine statistical significance at p ≤ 0.05.

RESULTS

A total of 128 patients (mean age 32.17±7.97 years in stapled and 34.11±8.47 years in hand-sewn groups) were randomized, with male predominance in both cohorts. Stapled anastomosis significantly reduced operative time (74.5 vs. 86.5 minutes) and surgical site infections (14.1% vs. 35.9%, p=0.004). No significant differences were observed in anastomotic leakage (3.1% vs. 4.7%) or hospital stay.

CONCLUSION

The use of stapled anastomosis in ileostomy reversal was associated with a significantly reduced incidence of surgical site infections and shorter operative duration compared to manual techniques. However, the occurrences of anastomotic leakage and the duration of hospital stay did not exhibit any statistically significant variation between the two groups. These findings suggest stapled anastomosis as a safe and efficient technique, offering clinical advantages without increasing complication rates. Broader multicenter studies with long-term follow-up are warranted to validate its role as a preferred option in stoma reversal surgery.

KEYWORDS

Ileostomy reversal; Stapled anastomosis; Hand-sewn anastomosis; Anastomotic leakage; Surgical site infection; Postoperative outcomes