Abstract

Background: Intestinal perforations requiring resection anastomosis of the gastrointestinal tract (GIT) or the formation and closure of temporary intestinal stoma are prevalent worldwide. This prospective comparative study was done to assess the efficacy and safety of single-layered anastomosis compared to a double-layered anastomosis.Methods: Patients undergoing intestinal anastomosis with either of these two techniques were observed prospectively for various outcome parameters like time taken for anastomosis, and that for entire surgery, postoperative complications, etc. Data obtained were analyzed for statistical significance by applying the chi-square test and student's “t-test.”Results: Duration for fashioning the anastomosis was significantly lesser for a single layer anastomosis than double (mean [±SD] for single layer was 19.57 ± 2.25 minutes and for double layer group was 30 ± 2.59 minutes, p=0.002). There was no statistical difference in the postoperative complications between the two groups. The postoperative incomplete intestinal obstruction was reported in three cases of the double layer group.Conclusion: Single-layered gastrointestinal anastomosis (GIA) resulted in a significant reduction in time, without any difference in complications. Additionally, it is easier to train surgical residents in the single-layered technique which is particularly important in the setting of a teaching institute and can be recommended for intestinal anastomosis.

Highlights

  • Intestinal perforations due to infectious diseases, trauma, malignancy, etc., requiring resection-anastomosis of the gastrointestinal tract (GIT) or formation and closure of a temporary intestinal stoma are prevalent procedures in India

  • A leaking anastomosis dramatically increases the morbidity and mortality associated with the operation: it can increase the length of hospital stay, the total cost of the treatment, and mortality [3]

  • The study assessed the efficacy of both groups in terms of the duration required to perform single and double-layered intestinal anastomosis, study post-operative complications like an anastomotic leak (AL) in the single and double-layered intestinal anastomosis, the outcome associated with single and doublelayered anastomoses and the duration of hospital stay in either of them and safety of single-layered anastomosis compared to a double-layer anastomosis

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Summary

Introduction

Intestinal perforations due to infectious diseases, trauma, malignancy, etc., requiring resection-anastomosis of the gastrointestinal tract (GIT) or formation and closure of a temporary intestinal stoma are prevalent procedures in India. A leaking anastomosis dramatically increases the morbidity and mortality associated with the operation: it can increase the length of hospital stay, the total cost of the treatment, and mortality [3] It has been a debatable issue regarding the outcomes of single-layered or double-layered anastomosis. Intestinal perforations requiring resection anastomosis of the gastrointestinal tract (GIT) or the formation and closure of temporary intestinal stoma are prevalent worldwide. This prospective comparative study was done to assess the efficacy and safety of single-layered anastomosis compared to a double-layered anastomosis

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