scholarly journals COMPARATIVE STUDY BETWEEN SINGLE LAYER VERSUS DOUBLE LAYER ANASTOMOTIC TECHNIQUE FOR SMALL INTESTINAL ANASTOMOSIS IN ADULTS

2021 ◽  
Vol 50 (4) ◽  
pp. 2555-2564
2017 ◽  
Vol 13 (2) ◽  
pp. 134-143 ◽  
Author(s):  
Tuhin Shah ◽  
RK Agarwal ◽  
RK Gupta ◽  
CS Agrawal ◽  
S Khaniya

Background: Intestinal anastomosis is essential to maintain the continuity after resection. There has been constant controversy due to various repair options. Adequate apposition can be achieved by either single- or double-layer anastomosis which may affect the post-operative outcome.Objective: To compare the outcome of single-layer versus double-layer anastomosis of small and large intestine.Method: This prospective comparative study was conducted over a period of 16 months, and included 78 patients who underwent intestinal anastomosis (without diverting stoma) after fulfilling inclusion and exclusion criteria. They were randomized into double-layer and single-layer intestinal anastomosis groups by a computer generated series. Double layer anastomosis was constructed using inner continuous Polyglactin 3-0 and outer interrupted Silk 3-0, while single layer anastomosis was done with interrupted PDS 2-0.Result: The mean age was 39.79±17.78 years. A total of 59% were operated in emergency room while 41% in elective setting. Overall mean time for anastomosis was 31.81±6.03 (21-50) minutes. In double- and single-layer intestinal anastomosis mean time was 34.35±5.80 (26-50) and 29.13±5.08 (21-45) minutes respectively, which was statistically significant (p value < 0.05). Single-layer was completed 5 minutes earlier than double layer anastomosis in average. Clinical anastomotic leak was seen in six (7.7%) patients, three in each group. Eight (10.3%) patients had surgical site infection: 3 in double-layer and 5 in single-layer groups. One (1.3%) mortality was seen, from single-layer anastomosis group.Conclusion: Single-layer anastomosis can be constructed in significantly shorter time with similar complication rate when compared to doublelayer anastomosis.Health Renaissance 2015;13(2): 134-143


2020 ◽  
Vol 7 (9) ◽  
pp. 2991
Author(s):  
Ajit Kumar ◽  
Vinod Kumar

Background: There are still conflicting views regarding suitability of single layer and double layer anastomotic technique. This prospective single blinded randomized comparative study conducted at Rajendra Institute of Medical Sciences to assess various aspects viz. safety, efficacy, duration of hospital stays and chances of perforation in single- and double-layer anastomotic surgery.Methods: 26 patients each in single layer and double layer anastomosis group were included in the study.  Single layer intestinal anastomosis was carried using extramucosal technique with 2-0 vicryl suture (round body). Double layer anastomosis was carried out using interrupted 3-0 silk lembert sutures for the outer layer and a continuous 2-0 vicryl for the inner layer. End to end colocolic, end to end ileocolic, 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, cost incurred, and length of hospital stay.Results: Findings of the study indicated that single layer is economical in comparison to double layer anastomosis and took significant less time to operate. There was no significant difference in hospital stay of the patients in two groups. There was no anastomotic leak in group-S (single layer) while one (3.8%) patient in group-D (double layer) suffered from anastomotic leak.Conclusions: It was concluded that single layer anastomosis method is beneficial and safe as it required less operative time, suturing material and no leak took place after surgery.


2021 ◽  
pp. 64-66
Author(s):  
Sudhansu Sarkar ◽  
Sourav Das

A comparative study between Single Layer versus Double Layer Intestinal Anastomosis,was undertaken at Department of Surgery,Bankura Sammilani Medical College & Hospital,Bankura from April 2019 – September 2020,which included 74 patients, comprising 2 groups: Group A-Single layer and Group B- Double layer with equal number of patients randomly allotted in each group. More number of patients had anastomotic leak in Group B than Group A, though not statistically significant. Difference of Mean Duration of Anastomosis with both groups is statistically significant.Mean Duration of Hospital Stay with both groups is statistically insignificant. Although more number of patients had anastomotic leaks in Group B than Group A,it was statistically insignificant.


2018 ◽  
Vol 1 (2) ◽  
pp. 98-101 ◽  
Author(s):  
Amar Gurung ◽  
Santosh Shrestha ◽  
Devendra Shrestha ◽  
Suresh Raj Paudel ◽  
David Shrestha ◽  
...  

Objective: To determine the efficacy of single layer intestinal anastomosis to double layer technique in terms of anastomotic healing. Materials and Methods: Fifty patients who underwent intestinal anastomosis in the Department of Surgery, Western Regional Hospital from June 2014 to May 2016 were taken for this comparative study and divided equally in two groups, 25 each (single layer and double layer). Results: Of the total fifty cases, twenty-five cases included in each group, there was no leakage in single layer group while 1 patient had leakage in double layer group which was statistically insignificant. Conclusion: Single layer interrupted intestinal anastomosis is simple to carry out and is as efficacious as double layer anastomosis in terms of postoperative anastomotic leak.


Author(s):  
Arvind Rai ◽  
Sukantth R. J.

 Background: Intestinal anastomosis is one of the common surgeries for cases like bowel obstruction, incarcerated hernias, benign and malignant tumours of small and large bowel. The ideal intestinal anastomosis does not leak and allow normal function of the gastrointestinal tract. This study compared single layer versus double layer  intestinal anastomosis in terms of duration, postoperative complications like anastomotic leak.Methods: A total of 100 patients admitted in Hamidia hospital, based on history and clinical examinations and radiological examinations, placed in two groups, group A (single layer anastomosis) and group B (double layer anastomosis) and were operated by a qualified surgical specialist. Data analysis of anastomotic time, anastomotic leak was done and statistical tests of significance were applied. A p value less than 0.05 is considered as significant.Results: In group A (single layer) the time required to perform in 30 (60%) patients is between 16-20 minutes. In double layer, maximum were done in between 26 to 30 minutes, 32 (64%). In our study of 100 patients, there were 6 anastomotic leaks, of which four of them were in group A (single layer) and 2 of them in group B (double layer).Conclusions: In our study, the duration required to perform a single layer intestinal anastomosis is significantly lesser when compared to double layer. There is no significant difference in anastomotic leak between two groups. Less time with no difference in complications, a move towards single layer anastomosis should be preferred.


2015 ◽  
Vol 6 (3) ◽  
pp. 264
Author(s):  
Rahul Saboo ◽  
Satish Deshmukh ◽  
Rajiv Sonarkar ◽  
Vijay P Agrawal ◽  
Prateek Shah

2019 ◽  
Vol 7 (2) ◽  
pp. 103
Author(s):  
Sohan Pal Singh ◽  
Divya Prakash ◽  
Dheeraj Raj Baliyan ◽  
Virendra Kumar ◽  
Vishal Saxena ◽  
...  

2015 ◽  
Vol 2 (1) ◽  
pp. 22-26
Author(s):  
Bilal Khattak ◽  
Faiz -Ur- Rahman ◽  
Irfan -Ul-Islam Nasir ◽  
Muhammad Iftikhar ◽  
Imtiaz Ahmad Khattak ◽  
...  

Objective:To evaluate the safety regarding anastomotic failure of single layer interrupted extra mucosal intestinal anastomosis in comparison with double layer intestinal anastomosisMethodology:This prospective comparative study was conducted in surgical A unit of Lady reading Hospital Peshawar from 1st June 2007 to 1st February 2008 (8 months).Patients were divided into two groups, each comprising 60 patients. First 60 consecutive patients were included in Group A, for single layer extra mucosal anastomosis while Group B included last 60 consecutive patients for double layer inverting anastomosis (continuous inner and interrupted outer Lambert sutures). All the cases were admitted through OPD and emergency. The safety of two techniques of anastomosis was analyzed by comparing the outcome in terms of complications.Results:In this study, anastomosis leakage occurred only in 4 (3.33%) patients, one (1.67%) in group A and three (5%) in group B with a P-Value 0.138. Mean age of patient in group A was 36.15 years (+/- 6.0 years) and in group B was 33.25 years (+/- 5.5 years).Conclusion:Single layer extra-mucosal anastomosis has least anastomotic leakage and other complication like wound infection, septicemia, and collection and burst abdomen than in patients with double layer investing anastomosis.


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