ABSTRACT
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.
ABSTRACT
Colonic anastomosis is mostly due to to primary colonic diseases like volvulus, carcinoma, strangulation, injuries and stricture .As a result intestinal ischaemia and gangrene develops and finally the affected bowel is resected and end to end anastomosis is done .The aim of the study is to evaluate the effectiveness and outcome of colonic anastomosis by single layer or double layer. Methods: 134 cases were selected for this study.69 patients were taken up for single layer and 65 for double layer anastomosis. Single layer anastomosis has a better outcome in terms of healing, less time consuming and minimal complications. Results: Single layer takes less time, post. Operative complications are minimal, duration of hospital stay is less and mortality and morbidity is reduced. Conclusion: Single layer anastomosis should be a preferred technique and a procedure of choice for colonic anastomosis.
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.