COMPARATIVE STUDY OF SINGLE LAYER INESTINAL ANASTOMOSIS AND DOUBLE LAYER INTESINAL ANASTOMOSIS

Abstract

Background: Gastrointestinal anastomosis is one of the most common procedures being performed in oesophagogastric, hepatobiliary, bariatric, small bowel and colorectal surgery. There are still conflicting views regarding suitability of single layer and double layer anastomotic technique. Methods: This comparative study was conducted at Patna Medical College and Hospital,Patna in which 48 patients were repaired with single layer anastomosis and 48 were repaired with double layer intestinal anastomosis. Single layer intestinal anastomosis was carried using extramucosal technique with 2-0 vicryl suture (round body). Double layer anastomosis was carried out using interrupted 2-0 vicryl suture for both inner (continuous) and outer ( Interrupted) layer.End to end colocolic,end to side ileocolic,end to end ileoileal,side to side ileoileal,end to end jejunoileal and end to end jejunojejunal anastomosis were performed. Each group was compared for anastomotic leak, time required to construct the anastomosis and length of hospital stay. Results: The mean time taken for anastomosis (15±2 minutes in single layer anastomosis versus 32±5 minutes in double layer) and the length of hospital stay was same in both the groups.There was 1 anastomosis leak in single layer anastomosis group and 3 in double layer group. Conclusion: It can be concluded that single layered extramucosal continuous intestinal anastomosis is equally safe and perhaps more cost effective than the conventional double layered method and may represent the optimal choice for routine surgical practice.