A comparative study of single layer continuous sutures versus double layer interrupted sutures in intestinal anastomosis

Rahul Saboo,Satish Deshmukh,Rajiv Sonarkar,Vijay P Agrawal,Prateek Shah

doi:10.7439/ijbar.v6i3.1729

Abstract

Objectives : The objective of the study was to compare single layer continuous intestinal anastomosis and double layer interrupted intestinal anastomosis in terms of time taken for the anastomosis and safety. Material & Methods : A prospective comparative study was carried out in the Department of Surgery NKPSIMS and RC, Nagpur from August 2011 to October 2013. All patients who underwent elective intestinal surgeries and bowel anastomosis and consented for the study were included in the study. Patients requiring gastric, duodenal and rectal anastomosis and patients in whom staplers were used were excluded from the study. 30 single layered continuous and 30 double layered interrupted intestinal anastomosis were performed. Data was analyzed using Student t test for continuous variables and Chi square test for categorical variables. Comparison was made in terms of time taken for anastomosis, anastomotic leak and other complications. Results : The mean duration of intestinal anastomosis for the double layer group was 33.06 minutes whereas for the single layer group, it was 23.6 minutes, which was found to be statistically significant. Anastomotic leak was reported in 2 patients in the double layer group and in 3 patients in the single layer group was found to be statistically insignificant. The other complications that included surgical site infection, re intervention and mortality were similar in both the groups. Single layered intestinal anastomosis does not carry any increased risk of anastomotic leak and other complications when compared to double layered intestinal anastomosis and can be constructed in a shorter time. Conclusion : Single layered intestinal anastomosis technique takes less time for construction and does not carry any increased risk of complications

Highlights

Intestinal anastomosis dates back to 1000 B.C., the era of Sushruta “The Great Indian Surgeon” where he described the use of black ants for intestinal anastomosis.[1]
Rahul Saboo et al/ A comparative study of single layer continuous sutures versus double layer interrupted sutures 265 elective intestinal surgeries and bowel anastomosis and consented for the study were included in the study
A total of 60 patients were included in the study. 30 patients underwent single layered continuous and 30 patients underwent double layered interrupted intestinal anastomosis

Summary

Introduction

Intestinal anastomosis dates back to 1000 B.C., the era of Sushruta “The Great Indian Surgeon” where he described the use of black ants for intestinal anastomosis.[1] Intestinal anastomosis has been successfully performed for more than 150 years using a variety of techniques, materials and devices. Hand sewn intestinal anastomosis is the most commonly used technique worldwide because of the availability and affordability of suture materials and familiarity with the procedure. Anastomosis may be performed by a double layered suturing technique or by a single layer technique. The potential shortcoming of the double layer intestinal technique is the risk of anastomotic stricture formation. The single layer extra mucosal anastomosis is popular, as advocated by Matheson of Aberdeen[2]. Single layer continuous intestinal anastomosis requires less time to fashion and has no increased risk of complications. This study is an attempt to compare the efficacy of single layer continuous sutures in intestinal anastomosis

Objectives

Methods

Results

Conclusion