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| Home > Publications database > Influence of suture technique on anastomotic leakage rate—a retrospective analyses comparing interrupted—versus continuous—sutures |
| Home > Publications database > Influence of suture technique on anastomotic leakage rate—a retrospective analyses comparing interrupted—versus continuous—sutures |
| Journal Article | FZJ-2018-05505 |
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2019
Springer
Berlin
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Please use a persistent id in citations: doi:10.1007/s00384-018-3168-6
Abstract: Purpose While many hospitals consider a continuous sutured colonic anastomosis with monofilamental fiber the current state ofthe art, others have advocated for interrupted sutures as the gold standard. The aim of the study was to evaluate the influence ofsuture technique on leakage rate (primary endpoint), wound infections, postoperative stay, and mortality.Methods Retrospective analyses of 347 patients (273 elective, 74 urgent) over 6 years with a handsewn colonic anastomosis (190interrupted, 157 continuous), excluding sigma and rectum anastomosis. Demographic and surgical baseline characteristics wereused as competing predictors.Results Overall leakage rate was 9% but strongly dependent on suture technique (interrupted: 16%; continuous: 2.5%; p = 0.001)yielding an odds ratio of 5.10 [95% CI: 2.55, 6.71] (relative risk of leakage). No other variable showed a significant influence onleakage rate. Postoperative stay was prolonged in the interrupted suture group (23 ± 15 vs. 16 ± 11 days; p = 0.000, attributableeffect 7.5 days [4.7, 10.3]).Conclusions Our results indicate a highly significant reduction of anastomotic leakage rate and postoperative stay that generalizeto the underlying population by continuous sutures in handsewn colonic anastomosis. In the absence of randomized prospectivestudies, the current results provide the yet strongest evidence for the superiority of continuous sutures.Keywords Anastomotic leakage . Interrupted suture technique . Continuous suture technique . Anastomotic technique . Colonanastomosis
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