A Comparative Study between Single versus Double Layered Bowel Anastomosis in a Tertiary Care Hospital

ABSTRACT

Background: Intestinal anastomosis is a frequently performedprocedure equally in elective and emergency cases andtherefore, it is authoritative for surgeons and residents to beacquainted with the art of bowel anastomosis. The technique ofanastomosis is dependent upon the site, situation of the boweland the fundamental disease etiology, and the generalcomplaint of the subject. As per a recent Cochrane reviewcomparing the effectiveness of single layer and double layergastrointestinal anastomosisMaterials and Methods: The present prospective, randomizedcomparative study was conducted in the general surgicaldepartment of the Hospital for a period of 2 years. Subjectsrequiring intestinal resection were evaluated for eligibility to theward. All subjects received same antibiotics postoperativelylike Injection Ceftriaxone and Metronidazole including astandard postoperative care. Subjects were followed up for twoweeks after surgery. Any instant or late complications werenoted. All the data thus obtained was arranged in a tabulatedform and analyzed using SPSS software. Probability value ofless than 0.05 was considered as significant.Results: There were total 100 subjects included in the study,out of which 50 were managed by Single layered and 50 byDouble layered technique. The mean age of the subjects was37.53+/-4.22years. The mean duration of nasogastric tube insitu was 1.92±0.80 and 2.35 ± 1.03 days respectively in singleand double layer technique. The return of bowel soundpostoperatively was 2.45±1.13 days in single layer and 3.2 ±1.36 days in double layer technique. There was a significantdifference in both the groups. There was 1 case of anastomoticleak with double layered technique. Abdominal abscess wasseen in 2 cases each.Conclusion: The hospital stay duration, operating time wascomparatively lesser with single layer technique. It was alsocost effective and easy to perform.