scholarly journals Outcomes Assessment between Hand Sewn and Stapled Intestinal Anastomosis

2021 ◽  
pp. 59-63
Author(s):  
Zubair Ahmad Yousfani ◽  
Khenpal Das ◽  
Jabeen Atta ◽  
Ghullamullah Rind ◽  
Moomal Zoya ◽  
...  
Keyword(s):  
Anastomotic Leakage ◽  
Intestinal Anastomosis ◽  
Single Layer ◽  
Health Sciences ◽  
Proximal Jejunum ◽  
Intestinal Anastomoses ◽  
Anastomotic Failure ◽  
Group A ◽  
Group B ◽  
Made In

Objective: This study was conducted at the Department of Surgery of Liaquat University of Medical & Health Sciences, Jamshoro, Sindh, Pakistan for comparing the effectiveness of both methods: hand sewn and stapled intestinal anastomosis and to find a better comparatively to be more efficient. Methods: A total of 70 patients were encompassed who underwent intestinal anastomoses from proximal jejunum to 2/3rd of proximal distal rectum. All patients were assigned to two different groups A and B each encompassing of 35 cases. In group A, the single layer continuous and in group B single layer patients intervallic serosubmucosal anastomosis was made by implementing the stitches approximately 6 mm at a distance integrating around 5.5 mm of the gut in its stretched direction axis evading individual mucosa. The patients were observed post operatively for anastomotic fiasco such as leakage. Results: Fourteen (14) out of 35 (2.5%) patients in group A developed anastomotic leakage . In group B, the interrupted serosubmucosal anastomoses were made in 26 patients in emergency and remaining were operated schedule wise. Five (7%) patients exhibited anastomotic leakage in group B. In group A, the continuous leakage in serousubmucosal anastomosis was 2.5% while in group B interrupted serousubmucosal anastomosis was 7%. Conclusion: It has observed in past studies that single layer interrupted stitches leakage is higher as compared to continuous. It is clear that anastomotic failure in group A is greater than group B but it not considerably substantial and hence both are remarkably efficient.  

scholarly journals Study of clinical outcome of patients undergoing intestinal anastomoses with single layer extramucosal technique and double layer anastomoses

2021 ◽  
Author(s):  
Arvind Rai ◽  
Sukantth R. J.
Keyword(s):  
Anastomotic Leak ◽  
Double Layer ◽  
Statistical Tests ◽  
Intestinal Anastomosis ◽  
Single Layer ◽  
Layer Versus ◽  
Intestinal Anastomoses ◽  
Significant Difference ◽  
Group A ◽  
Group B

 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.

scholarly journals Single Layer Extra-Mucosal Versus Double Layer Intestinal Anastomosis for Colostomy Closure: A Prospective Comparative Study

2021 ◽  
Vol 17 (2) ◽  
pp. 95-99
Author(s):  
Layth Saleh Owaid ◽  
Imad Wajeeh Al-Shahwani ◽  
Zuhair B. Kamal ◽  
Laith Naif Hindosh ◽  
Abbas Farman Abdulrahman ◽  
...  
Keyword(s):  
Double Layer ◽  
Intestinal Anastomosis ◽  
Single Layer ◽  
Anastomosis Group ◽  
Duration Of Hospital Stay ◽  
Group A ◽  
The Mean ◽  
Group B ◽  
Mean Cost ◽  
Mean Time

Background: The main objective was to compare the outcome of single layer interrupted extra-mucosal sutures with that of double layer suturing in the closure of colostomies. Subjects and Methods: Sixty-seven patients with closure colostomy were assigned in a prospective randomized fashion into either single layer extra-mucosal anastomosis (Group A) or double layer anastomosis (Group B). Primary outcome measures included mean time taken for anastomosis, immediate postoperative complications, and mean duration of hospital stay. Secondary outcome measures assessed the postoperative return of bowel function, and the overall mean cost. Chi-square test and student t-test did the statistical analysis.. Results:  Thirty-two patients were allocated to group A and 35 patients to group B. The mean time taken for anastomosis was significantly shorter in group A (23.25 ± 1.20 min in group A vs. 36.71 ± 1.93 min in group B; P<0.001). A significant shorter duration of hospital stay was seen in group A (7.00 ± 1.778 days in group A vs. 9.74 ± 1.990 days in group B; P<0.001). The detection of bowel sound was substantially quicker in group A as compared to group B (4.56 ± 0.50 days in group A vs. 6.46±0.50 days in group B; P<0.001). There was no significant discrepancy between the two groups regarding anastomotic leak rates (P= 0.543). The mean cost of double layer intestinal anastomosis method was significantly higher than that of single layer anastomosis (P<0.001). Conclusions: The use of single layer extra-mucosal anastomosis of the intestine has the advantage of taking less time, less morbidity and cost-effective to perform with the same rate of anastomotic leak in the closure of colostomy.

scholarly journals Surgical Technique of Small Bowel Transplantation in a Large Animal Model

2010 ◽  
Vol 79 (2) ◽  
pp. 281-287
Author(s):  
Martin Oliverius ◽  
Dušan Král ◽  
Eva Honsová ◽  
Alena Lodererová ◽  
Michal Kudla ◽  
...  
Keyword(s):  
Surgical Technique ◽  
Intestinal Anastomosis ◽  
Single Layer ◽  
Vascular Anastomosis ◽  
Technical Failure ◽  
Intestinal Anastomoses ◽  
Significant Difference ◽  
Group A ◽  
The Impact ◽  
Group D

An experiment was carried out on pigs during preparation of a clinical project of intestinal transplantation. The objective of this study was to find the best surgical technique of vascular and intestinal anastomosis in different experimental settings (animals with and without immunosuppression) which could have a major impact on everyday veterinary practice. Transplantation was performed in 43 pigs. In the surgical part of the experiment we examined the most suitable surgical technique of vascular anastomosis. A running continuous single-layer seromuscular suture was used for all types of intestinal anastomoses. With regard to vascular anastomosis, the animals were divided into two groups. In group 1 (n = 18) one animal was both donor and recipient of the intestinal graft. Anastomoses were constructed to the mesenteric vessel bed. In group 2 (n = 25), one animal was the graft donor and another was the graft recipient, with revascularization to the central vessel bed. In the second part of the study, we examined the impact of immunosuppressive drug administration on acute cellular rejection and animal survival. Animals that died due to technical failure and reasons unrelated to transplantation were excluded from the evaluation (19 pigs). A total of 24 pigs were included in the second part of the study. The animals were divided into four experimental groups. Group A - autotransplantation (n = 3), group B - allotransplantation on tacrolimus monotherapy (n = 7), group C on combined immunosuppression with tacrolimus and sirolimus (n = 8), and control group D - without immunosuppression (n = 6). Results: A high rate of vascular complications occurred in the first group; 67% (12 out of 18). In the second group, the rate of complications was reduced to 12% (3 out of 25). In the second part of the study the shortest survival was found in group D and the longest in group A. In neither of the immunosuppressed groups (B + C) did we find any significant difference in survival. No complication with the healing of intestinal anastomosis was found in any group. In conclusion we can state the single-layer continuous running suture was safe for all kinds of intestinal anastomoses. Vascular reconstruction to the central vessels was safer for graft survival.

scholarly journals Single Layer Extra-Mucosal Interrupted Anastomoses; Revalidated

2015 ◽  
Vol 2 (1) ◽  
pp. 22-26
Author(s):  
Bilal Khattak ◽  
Faiz -Ur- Rahman ◽  
Irfan -Ul-Islam Nasir ◽  
Muhammad Iftikhar ◽  
Imtiaz Ahmad Khattak ◽  
...  
Keyword(s):  
Comparative Study ◽  
Double Layer ◽  
Intestinal Anastomosis ◽  
Single Layer ◽  
P Value ◽  
Burst Abdomen ◽  
Group A ◽  
Prospective Comparative Study ◽  
Anastomosis Leakage ◽  
Group B

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.

scholarly journals A COMPARATIVE STUDY BETWEEN SINGLE LAYER VERSUS DOUBLE LAYER INTESTINAL ANASTOMOSIS

2021 ◽  
pp. 64-66
Author(s):  
Sudhansu Sarkar ◽  
Sourav Das
Keyword(s):  
Comparative Study ◽  
Double Layer ◽  
Intestinal Anastomosis ◽  
Single Layer ◽  
Layer Versus ◽  
Medical College ◽  
Number Of Patients ◽  
Significant Difference ◽  
Group A ◽  
Group B

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.

COMPARATIVE STUDY OF SINGLE LAYER CONTINUOUS VERSUS SINGLE LAYER INTERRUPTED EXTRA MUCOSAL TECHNIQUES IN SMALL INTESTINE ANASTOMOSIS

2021 ◽  
pp. 40-41
Author(s):  
Md Noman ◽  
Shri Krishna Ranjan
Keyword(s):  
Small Intestine ◽  
Postoperative Complications ◽  
Comparative Study ◽  
Hospital Stay ◽  
Intestinal Anastomosis ◽  
Single Layer ◽  
Anastomosis Group ◽  
Group A ◽  
Group B ◽  
Demographic Features

Background: Intestinal anastomosis is most commonly performed surgical procedure both in emergency and elective settings therefore its leak and disruption is a common cause of post-operative morbidity and mortility. Gut anastomosis heals by the same mechanism as that of wound healing. The submucosa, is the strongest layer of gut wall therefore ideal anastomotic technique is the one which includes apposition and approximation of this layer. Aim:The outcome of comparative study of single layer continuous extra mucosal technique and single layer interrupted extra mucosal technique for the anastomosis of small bowel. Methods:This was a prospective study based on randomization and was carried out in surgery department of ANMMC&H, Gaya from 1 st March 2019 to 29th February 2020. Total Fifty patients were included in study requiring small intestine anastomosis and were divided in two groups based on randomization. Group Aincluded those patients in which the anastomosis performed by single layer continuous extra mucosal technique and Group B patients underwent single layer interrupted extramucosal technique for creation of anastomosis, Group Aincluded 24 patients (n=24) and Group B 26 patients (n=26) . The demographic features, time taken to create anastomosis , postoperative complications , number of deaths if any and hospital stay in days were recorded on a printed proforma and data analysis was done through computer soft ware SPSS 16. Results: Group Aand B were similar as for as the demographic features, postoperative complications and duration of hospital stay are concerned. 4.2% patients of Group A and 7.7% of Group B developed anastomotic dehiscence with non signicant p value. Mean time taken for creation of anastomosis was 10.04 minutes in continuous extra mucosal anastomosis group (Group A ) and 19.2 minutes in interrupted extra mucosal anastomosis [Group B ] (p=0.0001) Overall hospital mortality was 2%. Conclusion: Single layer continuous extra mucosal technique is as safe as interrupted extra mucosal anastomosis technique but can be performed in shorter time and can be a cost effective alternative for construction of bowel anastomosis.

scholarly journals A comparative study of suturing technique of intestine between extra-mucosal single layer interrupted and continuous all layers: a single center experience

2021 ◽  
Author(s):  
Manoranjan Kar ◽  
Somu Singhal ◽  
Bismoy Mondal ◽  
Arijit Roy
Keyword(s):  
Comparative Study ◽  
Hospital Stay ◽  
Intestinal Anastomosis ◽  
Single Layer ◽  
P Value ◽  
Bowel Anastomosis ◽  
Duration Of Hospital Stay ◽  
Group A ◽  
The Mean ◽  
Group B

Background: Gastrointestinal anastomosis has been excited interest in our day to day surgical practice. We have compared efficacy, advantages, disadvantages, and complications following intestinal resection-anastomosis using extra-mucosal interrupted single layer suturing or continuous all layer suturing.Methods: This comparative study included 50 cases (either in emergency or elective undergoing bowel resection and anastomosis), comprising of 2 Groups (25 cases in each Group) between January 2019 to June 2021 at Midnapore Medical College and Hospital. Patients data, operative findings, duration of anastomosis and length of hospital stay, post-operative complications of all patients were followed till discharge.Results: Our comparative study have shown that- the mean duration for intestinal anastomosis in Group A (extra-mucosal interrupted single layer) and Group B (continuous all layers) were 21.43 minutes and 14.35 respectively. Considering duration of the anastomosis continuous all layers intestinal anastomosis appears to represent in shorter duration, anastomotic leak was noted in 3 patients (6%). Anastomotic leak was observed in 1 patient extra-mucosal interrupted single layer bowel anastomosis whereas two patients in the Group of continuous all layered bowel anastomosis had leak (p value 0.5-not significant) and the mean duration of hospital stay in the Group A and Group B were 7.32 days and 7.92 days respectively. (p value -insignificant).Conclusions: Duration required to perform a continuous all layer bowl anastomosis is lesser when compared to an extra-mucosal interrupted single layer intestinal anastomosis. There is no significant difference in complications, final outcome and duration of hospital stay between two Groups.

scholarly journals Single-Layer Versus Double Layer Intestinal Anastomosis of Small Bowel at Nepalgunj Teaching Hospital

2015 ◽  
Vol 12 (1) ◽  
pp. 35-38 ◽  
Author(s):  
A Pathak ◽  
MD Aklakhur Rahaman ◽  
SM Mishra
Keyword(s):  
Small Bowel ◽  
Wound Infection ◽  
Anastomotic Leakage ◽  
Double Layer ◽  
Single Layer ◽  
Medical College ◽  
Group A ◽  
Group B ◽  
Time Required ◽  
Resection And Anastomosis

Background: Resection and anastomosis of small bowel is one of the common surgical procedure encountered in routine and emergency cases. There are various techniques of anastomosing the resected intestine.Objectives: To know the efficacy of single layer anastomosis over double layer anastomosis in terms of anastomotic leakage, wound infection, mortality and time consumed.Methods: A comparative cross sectional analytical study was carried out at department of General Surgery at Nepalgunj Medical College Teaching Hospital, Kohalpur, Banke, Nepal from January 2013 to December 2013. Altogether 62 patients who underwent resection and anastomosis of small bowel were considered for this study. Patients who were included in this study were equally divided into two groups. Group A (n=32) underwent single layer anastomosis and group B (n=30) were subjected to double layer anastomosis. In both the groups anastomotic leakage, wound infection, mortality and time consumed were recorded and compared.Results: Altogether 62 patients were included in the study. The study showed anastomotic leakage 3 (9.37%) in Group A and 2 (6.67%) in Group B. Wound infection was 6 (18.75%) in Group A and 4(13.33%) in Group B and mortality was observed in only 1(3.12%) patient in Group A due to uncontrolled sepsis. There was no statistical difference between the two groups in anastomotic leakage, wound infection and mortality as shown by respective p (0.696, 0.562, 0.329) values. However the time required for single layer bowel anastomosis was less in comparison to double layer bowel anastomosis.Conclusion: Based on our data, the technique of single layer of bowel anastomosis does not increase the rate of anastomotic leakage, wound infection and mortality however time required for anastomosis is less as compared to double layer anastomosis. Therefore this study concludes that there is no added benefit of double layer of anastomosis over single layer bowel anastomosis.Journal of Nepalgunj Medical College Vol.12(1) 2014: 35-38

scholarly journals A comparative study between single layer versus double layer closure in ileostomy reversal

2014 ◽  
Vol 6 (2) ◽  
pp. 43-46 ◽  
Author(s):  
Sushil Mittal ◽  
Harnam Singh ◽  
Gurpreet Singh ◽  
Anand Munghate ◽  
Anjna Garg ◽  
...  
Keyword(s):  
Double Layer ◽  
Indian Subcontinent ◽  
Intestinal Anastomosis ◽  
Single Layer ◽  
Ileostomy Closure ◽  
Layer Versus ◽  
Choice Of Procedure ◽  
Postoperative Leak ◽  
Group A ◽  
Group B

Background:  Ileal perforation peritonitis is a common surgical emergency in the Indian subcontinent and in tropical countries. Formation of an intestinal stoma is frequently a component of surgical intervention for diseases of the small bowel. The technique for stoma reversal has remained controversial is the use of either one or two layers of sutures for anastomosis.Methods:  Sixty patients with ileostomy were taken for study .These patients divided in two groups A and B, 30 each. These patients were taken up for ileostomy closure in single layer (group A) (n-30) &double layer (group B) (n-30). Results: 60 Patients of ileostomy were studied, divided equally in 2 groups, A decreased intra operative time was seen in Group A when compared with Group B with no any significant comparative complication in these groups. Conclusion: Two-layer anastomosis for ileostomy closure offers no definite advantage over single layer anastomosis in terms of postoperative leak and other complications. Single layer ileostomy closure technique is safe, easy to perform and simply to taught. Considering duration of the anastomosis procedure and medical expenses single-layer intestinal anastomosis may prove the choice of procedure for most of the surgeons. DOI: http://dx.doi.org/10.3126/ajms.v6i2.10080Asian Journal of Medical Sciences Vol.6(2) 2015 44-47

scholarly journals Comparison of two different techniques of uterine closure in caesarean section: Continuous single layer technique versus Babu and Magon technique

2018 ◽  
Vol 7 (6) ◽  
pp. 2197
Author(s):  
S. Vinayachandran ◽  
Vedhapriya Sudhakar
Keyword(s):  
Caesarean Section ◽  
Elective Caesarean Section ◽  
Single Layer ◽  
Adverse Outcomes ◽  
Caesarean Scar ◽  
Duration Of Surgery ◽  
Layer Technique ◽  
Observational Prospective Cohort Study ◽  
Group A ◽  
Group B

Background: To compare size of the caesarean scar and residual myometrial thickness (RMT) between continuous single non-interlocking and Babu and Magon technique for uterine closure following primary elective caesarean section (CS).Methods: An observational prospective cohort study was conducted at 6 weeks and 4 months postpartum following primary elective CS. Group A included 25 patients who underwent continuous single layer technique and Group B included 25 patients who underwent Babu and Magon technique for uterine closure. Baseline demographic profile, obstetric score, details of the CS and associated complications were studied. Two-dimensional Transvaginal ultrasonography (TVS) measurements of the length, width and depth of the caesarean scar and RMT were compared.Results: Mean age of study population was 29.6 years. Malpresentation (44%) was the most common indication for CS. Mean Bishops score at the time of CS was <4. The duration of surgery (-2.8 min, 37.96 ±5.660min) and estimated amount of blood loss (-51.6 ml, mean 671.20 ±136.208ml) was less in Group A compared to Group B (40.76 ±4.68min, 722.80±132.083ml respectively). The caesarean scar measurements were similar in both groups at both visits. The mean RMT in Group B at 6 weeks and 4 months postpartum (8.05mm±2.06 and 7.10mm±2.04 respectively) was statistically higher than Group A (6.23mm ± 1.76 and 5.36mm ± 1.70 respectively), p=0.002.Conclusions: We conclude that Babu and Magon technique for uterine closure in caesarean section could result in better healing of the scar and probably reduce the adverse outcomes in subsequent pregnancies.

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