Milind Patil and Anand Ratra*
Department of General Surgery, SSG Hospital, IndiaFulltext PDF
Background: The traditional double layered intestinal anastomosis incorporates large amount of ischemic tissue in the suture line causing luminal narrowing and fistula formations. Single layered anastomosis done through continuous extra mucosal suturing has shown to be safe and causes fewer complications. Objective: To compare post-operative anastomosis leakage, duration required to perform single and double layered intestinal anastomosis, cost effective of suture material used in single and double layered intestinal anastomosis. Methods: The patients selected for this study were admitted with various clinical conditions requiring resection and anastomosis of small or large bowel. A total of 100 patients were included in the study. The patients were alternatively allotted single-layered intestinal anastomosis group and double layered group. Results: Mean duration required to perform anastomosis in Group A is 18.23 ± 3.35 min and in Group B is 29.70 ± 2.74 min. The difference between the mean duration required for anastomosis between the two groups were statistically significant (p<0.0001). Single layered intestinal anastomosis was found to be more economical compared to double layer as the total number of suture packs required in double-layered anastomosis (Vicryl and silk) was 2, whereas in single-layer anastomosis only one pack of vicryl was used. Cases in Group A and Group B developed anastomotic leak and the difference was statistically insignificant. Conclusion: Our study concluded that there is statistically significant difference between the single layer anastomosis and double layer in terms of time taken to perform anastomosis; cost effectiveness of single layer anastomosis, however there is no difference in recovery of bowel function, postoperative anastomotic leak.
Patil M, Ratra A. Prospective Study of Extramucosal Single Layer Interrupted Suture vs. Conventional Two Layer Repair of Intestinal Anastomosis. Clin Surg. 2020; 5: 2916.