Stricture complication in digestive surgery: Our histomorphological aid. Stapled versus handsewn sutures

Background. Surgeons variously estimate usage of mechanical staplers in digestive surgery especially about the increase of the incidence of late complications like stricture (as some authors refer). We report a histomorphological aid to the comparison of staplers and handsewn sutures. Our aim was to observe at long term the healing process in the sutured tissue in the canine gastro-enteric tract. Methods. We describe three histological pieces: one manual suture in a dog which was euthanatized and necropsied 5 months after operation and two mechanical sutures performed in two different dogs: one died because of a gastric torsion 18 months after the operation while the other was euthanatized 5 months after the operation. The histomorphological study has been carried out with a peculiar cutting (Exact) and including method which lets the staples in situ. Results and conclusions. Compared analysis showed that cicatrization goes on better in stapled than in hand sutured tissue.