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Abstract
Background: The choice between hand-sewn and stapled techniques for stoma closure in pediatric patients remains a key surgical decision. Each method has distinct advantages, with outcomes influenced by operative time, intraoperative blood loss, postoperative recovery, and complication rates. This study aimed to compare early outcomes of both techniques in children.
Methods: A randomized controlled trial was conducted at the Department of Pediatric Surgery, LUMHS, Jamshoro, from September 16, 2022, to March 15, 2023. A total of 160 pediatric patients undergoing ileostomy or colostomy closure were randomized into two groups: Group A (hand-sewn) and Group B (stapled), with 80 patients each. Outcomes assessed included operative time, intraoperative blood loss, return of bowel activity, hospital stay, and complications (anastomotic leak and surgical site infection). Data were analyzed using SPSS version 25.
Results: The stapled technique significantly reduced operative time (77.99 ± 13.04 vs. 91.78 ± 17.71 minutes, p=0.0001) and hospital stay (13.05 ± 3.82 vs. 15.21 ± 4.82 days, p=0.002). However, intraoperative blood loss was higher in the stapled group (22.85 ± 10.89 vs. 18.66 ± 6.70 ml, p=0.004). Rates of anastomotic leak (5.0% vs. 7.5%, p=0.373) and surgical site infection (30.0% vs. 35.0%, p=0.500) were comparable. No significant difference was observed in return of bowel activity (p=0.442).
Conclusion: Both techniques are safe and effective. The stapled method offers shorter operative time and hospital stay but slightly higher blood loss. Technique selection should be individualized.