A comparative study of single layer interrupted extramucosal (serosubmucosal) and double layer intestinal anastomosis
Journal Title: International Journal of Allied Medical Sciences and Clinical Research - Year 2016, Vol 4, Issue 1
Abstract
INTRODUCTION Intestinal anastomosis is the establishment of communication between two formerly distant portions of the intestine. A significant proportion of the operations on the gastrointestinal tract involve the repair of the gut and it is this aspect of surgery of alimentary canal which is associated with dangerous complications. The breakdown of suture line or repaired site may result in peritonitis, fecal fistula and serious or fatal septic complications. Anastomotic breakdown remains a major cause of morbidity and mortality and prolonged stay after operations on the gastrointestinal tract. Of the various methods of intestinal anastomosis, two layered interrupted anastomosis using various types of suture material is the most common type used by surgeons worldwide. However, recently several reports have appeared advocating the benefits of single layer extramucosal (serosubmucosal) anastomosis which causes less narrowing of the lumen and maintains good vascularity of anastomotic site. Further, this anastomosis requires less time to fashion, costs less than any other method and have a lower risk of complications and leakage. OBJECTIVE The purpose of this study is to compare the utility of single layer interrupted extramucosal (serosubmucosal) anastomosis over the conventional double layer intestinal anastomosis in emergency as well as elective laparotomy cases and to compare their results. MATERIALS AND METHODS Total 50 patients were included, divided into two groups of 25 each. In study group, Single Layer Extramucosal Anastomosis using Silk 3-0 Round Body was performed. In control group, conventional Double Layer Anastomosis using Vicryl 3-0 Round Body and Silk 3-0 Round Body was performed. RESULTS • The time taken for anastomosis in single layer anastomosis was less than that in control group in both elective as well as emergency cases. • Early return of bowel function with less complication rates in study group. • Single layer anastomosis costs less than two layer technique. CONCLUSION Single layer interrupted extramucosal (serosubmucosal) anastomotic technique can be easily applied in surgical practice especially in emergency situations because it will not only save the precious time of surgeons as well as anesthetists, but also will be beneficial to the patient.
Authors and Affiliations
Dr Yogendra
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