[Manual suture versus/or mechanical suture (from the Italian viewpoint)].

Mechanical suturing has become widespread in Italy in recent years, especially for anastomoses between the large intestines and the rectum and between the esophagus and the stomach or small intestine; many chest surgeons also use this type of suture. Basically, mechanical suturing is preferred for anastomoses for which the manual technique has proved difficult, for example those low in the pelvis or high up in the chest. Few surgeons use mechanical suturing at sites where it is easy to suture by hand. Overall, experience with mechanical suturing has been positive, mainly because the number of conservative resections performed for rectal carcinoma has increased while the frequency of the so-called Miles operation has declined in recent years. Our own experience with mechanical suturing has been collected in the construction of colorectal (235 with mechanical suturing out of a total of 592), ileorectal and ileoanal anastomoses (45 ileorectal and 12 ileoanal anastomoses with mechanical suturing out of a total of 155 surgical operations).