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Comparison Study of Single Layer versus Double Layer Anastomosis in Bowel Surgery in Western India

Archana A. Nema, Professor, Dept. of Surgery, Surat Municipal Institute of Medical Education and Research, Surat, Gujarat 395101, India , Archana A. Nema

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New Indian Journal of Surgery 9(3):p 286-290, May-June 2018. | DOI: DOI: https://dx.doi.org/10.21088/nijs.0976.4747.9318.7

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Abstract

Introduction: Recently several reports have appeared advocating the benefits of single layer extramucosal (serosubmucosal) anastomosis over conventional double layer anastomosis. The present study has been conducted to compare single layer technique with double layer anastomosis and to see cost effectiveness of suture material used and time taken for procedure.

Methods: Total 100 patients (both males and females) requiring intestinal anastomosis admitted in the Department of General Surgery, SMIMER hospital, Surat from July 2012 to November 2014 were included. In postoperative period, patient was monitored for any unexplained fever, distension of abdomen, time taken for bowel movements to come, postoperative day on which patient passed flatus and postoperative day on which patient tolerated the food. The patients were also monitored for anastomotic leak, wound infection, intraabdominal abscess.

Results: Mean time taken for anastomosis in single layer technique was 11.34±2.65 minutes and for double layer technique was 23.58±4.36 minutes. (p <0.001) Mean hospital stay in single layer technique was 11.46±2.44 days while it was 11.57±2.35 days in double layer technique. (p 0.818) Total 5 patients out of 100 cases, developed wound infections (10%) and all cases were operated in emergency.

Conclusion: Single layer anastomosis requires less time to construct, cost effective, reduces the operation time, without increase in risk of anastomotic leak and other complications. So, we came to conclude that the single layer interrupted anastomosis is equivalent to the two layer traditional intestinal anastomosis.

Keywords: Intestinal Anastomosis; Single Layer; Double Layer; Bowel Surgery.

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DOI: DOI: https://dx.doi.org/10.21088/nijs.0976.4747.9318.7

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