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Comparative evaluation for safety, cost effectiveness, morbidity and mortality of single versus double layer intestinal anastomosis. | ||
| Medical Journal of Tikrit | ||
| Article 1, Volume 19, Issue 1, 2013, Pages 37-44 | ||
| Author | ||
| Hamid H. Sarhan | ||
| Abstract | ||
| Background: Controversy regarding single versus double layer intestinal anastomosis goes as back as 1887. Interrupted single layer is now widely considered to be the gold standard for intestinal anasotmosis. Objective: To evaluate the safety, cost effectiveness, morbidity & mortality of single layer interrupted intestinal anastomosis in comparison with double layer. Patient and methods: A prospective comparative study was conducted from December 2009 to January 2012 at Surgical Department, Tikrit Teaching Hospital. All patients requiring both elective and emergency small bowel intestinal anastomosis including gastro-intestinal and ileo-colic anastomosis were included. Total of sixty- four patients were included in this study. They were divided into two groups A and B. In group A, 28 patients were included in whom single layer interrupted extra mucosal anastomosis was done with 2/0 vicryl. In group B 36 patients underwent conventional double layered anastomosis with 2/0 vicryl. Results: Anastomotic leakage in single layered group was 3.6%, while in double layered group was 4.7%. Average time for the construction of the single layer anastomos is 20 min and in double layer was 35 min per operatively. Moreover, suture material consumption was more in two layered technique. The mean of hospital stay was 5.2 ±1.5 days in single layered group while it was 7.5± 1.8 days in double layered group. Conclusions: Single-layer serosubmucosal (extramucosal) technique is safe, easy & faster to perform, simply to taught, cost effective and with less anastomosis related morbidity and mortality. | ||
| Keywords | ||
| intestinal anastomosis; Single; extramucosal; double | ||
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