A comparative study between single v/s double layered intestinal anastomosis

BACKGROUND: Intestinal anastomosis is a common procedure both in elective emergency surgeries. The key to a successful anastomosis is the accurate reunion of two viable bowel ends with complete avoidance of tension. Double layer anastomosis incorporates a large amount of ischemic tissue into the suture line leading to tension and increased chance of leakage and luminal narrowing while a single layer anastomosis causes minimal damage to vascular plexus and bowel lumen. OBJECTIVES: To study advantages of single layer v/s double layer anastomosis. METHODS: The materials for the clinical study were collected from patients admitted to Indira Gandhi Institute Of Medical Sciences Patna. GROUP1-All single layer anastomosis was performed by using continuous synthetic absorbable monofilament 3-0 suture taking all layers of bowel wall except the mucosa in to the bite. GROUP2-All double layered anastomosis was performed using continuous silk 3-0 Lembert suture for outer layer and continuous running Vicryl 3-0 suture for inner layer. RESULTS: A total of 96 patients were included in the study. The average time taken for anastomosis was 9.12 min for single layer whereas for double layer it was 13.38 min. The mean time taken for return of bowel sounds for single layer anastomosis was 2.32 days whereas for double layer it was 3 days. The average duration of hospital stay was 5.9 days for single layer whereas for other group it was 7.29 days. CONCLUSION: Single layered extra mucosal anastomosis is much safer and cost effective than the conventional double layered method.