“Trials comparing handsewn with stapled anastomoses in colon and rectal surgery have not found statistical differences. Despite this, authors have differed in their conclusions as to which technique is superior. To help determine whether differences in patient outcomes are present, a meta-analysis of all trials was performed.”

“No clinically relevant difference in mortality, leak rate (clinical, radiologic, or total), or wound infection rates was seen between handsewn and stapled anastomoses. Although no difference was seen in local cancer recurrence rates, the trials available do not have sufficient power to determine with certainty that clinically relevant differences are not present, although they seem unlikely. The only differences shown between handsewn and stapled anastomoses in the colon and rectum are that patients undergoing stapled anastomoses are more likely to experience intraoperative technical mishaps and postoperative strictures”

MacRae HM, et al . Handsewn vs. stapled anastomoses in colon and rectal surgery: a meta-analysis. Dis Colon Rectum. 1998 Feb;41(2):180-9. Full Text for Emory Users