Single Layer Versus Double Layer Anastomosis of Small Intestine – A Comparative Study from Karnataka, India

Abstract

BACKGROUND Intestinal anastomosis is an operative procedure that is of importance in the practice of surgery. It is a very commonly performed technique in today’s surgical era. We wanted to study the postoperative complications like anastomotic leak and abscess formation and duration of hospital stay in single layer and double layer anastomosis and compare the same. METHODS In our prospective observational study, 80 patients were reviewed and were divided into 2 groups. Cases were allotted to either group based on the odd even method requiring single- and double-layer anastomosis, odd being single layer and even being double layer anastomosis. Intestinal anastomosis was carried out in single layer technique with delayed absorbable suture material and double layer technique with inner transmural layer with delayed absorbable suture material and seromuscular layer with non-absorbable suture material. RESULTS Each group had 40 patients, there was significant difference noted between the groups. Mean duration of hospital stay in single layer group was 17.85 ± 7.62 days and in double layer group was 26.20 ± 16.12 days (P = 0.043 *). In single group, mean time taken for anastomosis was 18.50 ± 1.73 and in double group was 29.05 ± 2.19. There was significant difference in time taken between two groups (P < 0.001). In single group, majority of subjects had no anastomotic Leak (95 %) and 5 % had leak. In double group 70 % had no leak and 30 % had leak. P value was statistically significant (P = 0.037). CONCLUSIONS Single layer anastomosis was better in terms of duration of hospital stay, postoperative anastomotic leaks and time taken for anastomosis. KEY WORDS Single Layer, Double Layer, Small Bowel, Duration of Hospital Stay, Anastomotic Leaks