A COMPARATIVE STUDY BETWEEN SINGLE LAYERED CONTINEUOUS AND DOUBLE LAYERED CONTINEOUS INTESTINAL ANASTOMOSIS

Abstract

Background - The history of intestinal anastomosis dates back to the time of Hippocrates. From earlier times to as late as the 19th century, most of the anastomoses were primarily performed for traumatic injuries of the gastrointestinal tract. The art of intestinal anastomosis has evolved over the last 150 years and especially after the advent of anesthesia in the late 19th century. Within the past 150 years, intestinal anastomosis has been transformed from a life threatening venture to a safe and routinely performed procedure1. There are various methods and materials for intestinal anastomosis which have been a topic of much discussion and debate. With the advent of various other techniques like sutureless anastomosis and stapled anastomosis, confusion exists about the best option. However the conventional sutured anastomosis still stands out as the gold standard procedure being practiced
throughout the world. Materials and Methods - The present study focuses on comparison between the classical double layered method of intestinal anastomosis and the single layered extramucosal continuous method of anastomosis. The present study was carried out in the Department of General Surgery, S.C.B. Medical College, Cuttack during the time period September 2021 to September 2022. A total of 97 patients were included in the study and were randomized into the two study groups. Group 1 underwent single layered extramucosal intestinal anastomosis, while group 2 was treated with the conventional double layered method. The intra operative and post-operative data collected were subsequently analyzed and observations made. The two groups were compared using the standard tests
of significance and conclusions were drawn. Results - Time taken for anastomosis (mean) , Ryle’s tube removed on POD (mean) , Return of bowel sounds on POD (mean) , Passage of motion on POD (mean) , Complications recorded ( Anastomotic leaks , Wound infection , Abdominal distension, Mortality ) , and Mean duration of hospital stay are less in single layered extra-mucosal continuous anastomosis on comparision to double layered continuous intestinal anastomosis . But reverse is seen in case of cost of suture material used. Conclusion – a single layered extramucosal continuous anastomosis is much safer and cost effective than the conventional double layered method.