Comparision of single and double layer intestinal anastomosis in Ahwaz educational hospitals (2005-2006)

Abstract

Backgrounds and aim: This study evaluated complications of intestinal anastomosis in urgent and elective patients with two methods: singleor double-layer anastomosis.Patients and methods: This case-control study was carried out from July 1, 2005 to Aug 31, 2006 (14 months) in 3 university hospitals. Patients who had an indication for intestinal anastomosis (urgent or elective) were included. In this study, 126 patients with an average age of 31.39±21.08 years were divided into two groups: single-layer (63 patients) and double-layer (63 patients) intestinal anastomosis. In the single-layer group, intestinal anastomosis was carried out in continuous or interrupted method with absorbable or non-absorbable suture. Double-layer anastomosis was carried out in internal layer with continuous suture and external layer with interrupted suture. Post-operation complications were evaluated for fistula, wound infection, intra-abdominal abscess and stricture of anastomosis site. All intestinal anastomoses were carried out with the hand-sewn method.Results: In single-layer intestinal anastomosis, 5 patients (7.9%) had wound infection, 2 patients (3.2%) intra-abdominal abscess and one patient (1.6%) enterocutaneous fistula, and in the two-layer group, 7 patients (11.1%) had wound infection, 2 patients (3.2%) intra-abdominal abscess and 4 patients (6.3%) fistula. No patient experienced stricture of the intestinal anastomosis site.Conclusion: Single-layer anastomosis is safe. Complications of singleor double-layer anastomosis were similar. In addition, we have decreased operation time and total cost by the single-layer method.