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A prospective comparative study of intestinal anastomosis, single layer extramucosal versus double layer

Pravin P. Dandi, Abhay S. Aaudichya, Iliyas A. Juneja, Bhavesh V. Vaishnani, Jatin G. Bhatt.

Abstract
Background: Intestinal anastomosis is an operative procedure that is of central importance in the practice of surgery. Intestinal anastomosis after resection of bowel may be of various types and techniques. This prospective comparative study is performed to evaluate the safety in term of anastomotic leak of single layer interrupted extramucosal technique as compared to conventional double layer technique.
Methods: The patients selected for this study are those who were admitted with various clinical conditions requiring resection and anastomosis of small or large bowel presented to P.D.U. Medical College & Hospital, Rajkot between a period of August 2012 to December 2014. A total of 50 patients were included in the study. All the patients above the age of 18 years and less than 60 years, requiring intestinal anastomosis on emergency or electively, were included in the study and those requiring anastomosis to esophageal, gastric and duodenal anastomosis were excluded and randomly allotted single layer and double layer groups and results such as anastomotic leak rate, duration for anastomosis, number of suture material required noted.
Results: Mean duration required for single layer anastomosis was 19.6 minutes and for double layer anastomosis was 29.5 minutes and double number of suture material used in double layer anastomosis with equal anastomotic leak rate (6%) in each group.
Conclusions: Single layer interrupted extramucosal technique required significantly less duration for anastomosis, is cost effective with no significant difference in anastomotic leak rate and as safe as conventional double layer technique.

Key words: Single layer anastomosis, Double layer anastomosis, Anastomotic leak



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