A comparative study of single layer extra mucosal versus conventional double layer anastomosis of intestines in elective and emergency laparotomy
DOI:
https://doi.org/10.18203/2349-2902.isj20195966Keywords:
Double layer anastomosis, Extra mucosal technique, Single layer anastomosisAbstract
Background: Gastrointestinal anastomosis has been a part of research since decades and is one of the key skills in surgeon’s armamentarium. This study compared the outcome of single layer anastomosis with double layer anastomosis.
Methods: The study was designed as a prospective comparative study and 29 cases were included in the study during December 2016 to September 2017, who consented for being part of the study. Patients were alternatively allotted into the either group. Group A underwent single layer anastomosis and Group B underwent double layer anastomosis. Outcome parameters were analysed in the form of ‘duration required to perform anastomoses, ‘duration of hospital stay’ and ‘dnastomotic leak.
Results: Mean duration required to perform anastomosis in Group A is 21.64±1.60 minutes and in Group B is 29.6±2.02 minutes. The difference between the mean duration required for anastomosis between the two groups were statistically significant (p<0.005). Mean duration of hospital stay in Group A was 12.35±1.72 days and Group B was 12±2.44 days (difference was statistically insignificant), 3 (10%) cases in Group A and 2 (6.8 %) cases in Group B developed anastomotic leak and the difference was statistically insignificant.
Conclusions: Our study concluded that there is statistically significant difference between the single layer anastomosis and double layer anastomosis in terms of time taken to perform anastomosis, however there is no difference in postoperative anastomotic leak and duration of hospital stay.
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References
Zinner MJ, Ashley SW. Maingot's Abdominal operations. 12th edition. New York: McGraw-Hill's; 2013: 585-795.
Garude K, Tandel C, Rao S, Shah NJ. Single Layered Intestinal Anastomosis: A Safe and Economic Technique. Indian J Surg. 2013;75(4):290–3.
Edward E. Whang. Small intestine. In: Brunicardi, Billian A, Dunn D, Hunter, Pollock RE. Schwartz Manual of Surgery. 8th edition. New York: McGraw-Hill; 2005: 702-732.
Brooks DC, Zinner MJ. Surgery of the Small and Large Bowel. In: Zinner MJ, editor. Maingot's Abdominal operations. 10th Ed. Stamford: Appleton and Lange; 1997: 1309-1310.
Travers B. Enquiry into the Process of Nature in Repairing Injuries of the Intestine. London: Longman, Rees, Orme, Brown, and Green:1812.
Ceraldi CM, Rypins EB, Monahan M, Chang B, Sarfeh IJ. Comparison of continuous single layer polypropylene anastomosis with double layer and stapled anastomoses in elective colon resections. Am Surg. 1993;59(3):168-71.
Hautefeuille P. Gastrointestinal suturing. Apropos of 570 sutures performed over a 5-year period using a single layer continuous technic. Chirurgie; memoires de l'Academie de chirurgie. 1976 Feb;102(2):153-65.
Burson LC, Berliner SD, Strauss RJ, Katz P, Wise L. Telescoping anastomosis of the colon: a comparative study. Dis Colon Rectum. 1979;22(2):111-6.
Maurya SD, Gupta HC, Tewari A, Khan SS, Sharma BD. Double layer versus single layer intestinal anastomosis: a clinical trial. Int Surg. 1984;69:339-40.
Burch JM, Franciose RJ, Moore EE, Biffl WL, Offner PJ. Single-layer continuous versus two-layer interrupted intestinal anastomosis: a prospective randomized trial. Ann Surg. 2000;231(6):832-7.
Ordorica-Flores RM, Bracho-Blanchet E, Nieto-Zermeño J et al. Intestinal anastomosis in children: a comparative study between two different techniques. J Pediatr Surg. 1998 Dec;33(12):1757-9
Burch JM, Franciose RJ, Moore EE, Biffl WL, Offner PJ. Single-layer continuous versus two-layer interrupted intestinal anastomosis: a prospective randomized trial. Ann Surg. 2000 Jun;231(6):832-7.
Kar S, Mohapatra V, Singh S et al. Single Layered Versus Double Layered Intestinal Anastomosis: A Randomized Controlled Trial. J Clin Diagn Res. 2017 Jun; 11(6): PC01–PC04.
Khan RAA, Hameed F, Ahmed B, Dilawaiz M, Akram M. Intestinal anastomosis: comparative evaluation for safety, cost effectiveness, morbidity and complication of single versus double layer. Professional Med J. 2010;17(2):232-4.
Sajid MS, Siddiqui MR, Baig MK. Single layer versus double layer suture anastomosis of the gastrointestinal tract. Cochrane Database Syst Rev. 2012;1.
