A comparative study of single layer continuous sutures versus double layer interrupted sutures in intestinal anastomosis
DOI:
https://doi.org/10.7439/ijbar.v6i3.1729Keywords:
heart rate variability, time domain, body mass index, cold pressor testAbstract
Objectives : The objective of the study was to compare single layer continuous intestinal anastomosis and double layer interrupted intestinal anastomosis in terms of time taken for the anastomosis and safety. Material and Methods : A prospective comparative study was carried out in the Department of Surgery NKPSIMS and RC, Nagpur from August 2011 to October 2013. All patients who underwent elective intestinal surgeries and bowel anastomosis and consented for the study were included in the study. Patients requiring gastric, duodenal and rectal anastomosis and patients in whom staplers were used were excluded from the study. 30 single layered continuous and 30 double layered interrupted intestinal anastomosis were performed. Data was analyzed using Student t test for continuous variables and Chi square test for categorical variables. Comparison was made in terms of time taken for anastomosis, anastomotic leak and other complications. Results : The mean duration of intestinal anastomosis for the double layer group was 33.06 minutes whereas for the single layer group, it was 23.6 minutes, which was found to be statistically significant. Anastomotic leak was reported in 2 patients in the double layer group and in 3 patients in the single layer group was found to be statistically insignificant. The other complications that included surgical site infection, re intervention and mortality were similar in both the groups. Single layered intestinal anastomosis does not carry any increased risk of anastomotic leak and other complications when compared to double layered intestinal anastomosis and can be constructed in a shorter time. Conclusion : Single layered intestinal anastomosis technique takes less time for construction and does not carry any increased risk of complicationsDownloads
References
Singh RK, Vyas MK. Surgical procedures in Sushruta Samhita. International Journal of Research in Ayurveda and Pharmacy 2011; 2(5):1444
Damesha N, Lubana PS, Jain DK, Mathur R. A Comparative Study of Sutured and Stapled Anastomosis in Gastrointestinal Operations. The Internet Journal of Surgery 2008; 15(2).
Burch JM, Franciose RJ, Moore EE, Biffl WL, Offner PJ. Single-layer continuous versus two-layer interrupted intestinal anastomosis: a prospective randomized trial. Ann Surg 2000; 231(6):832-837.
Aslam V, Bilal A, Khan A, Bilal M, Zainulabideen, Ahmed M. J Ayub Med Coll Abbottabad 2008; 20(3):6-9.
Khan RAA, Hameed F, Ahmed B, Dilawaiz M, Akram M. Intestinal anastomosis; Comparative evaluation for safety, cost effectiveness, morbidity and complication of single versus double layer. Professional Med J 2010; 17(2):232-234.
Khair MA, Uddin MA, Khanam F, Bhuiyan MR, Reza E, Rahman MH, Shawon MR. Mymensingh Med J 2013;22(2):237-40.
Irvin TT, Goligher JC, Johnston D: A randomized prospective clinical trial of single-layer and two-layer inverting intestinal anastomoses.Br J Surg 1973;60:457-460.
Everett WG: A comparison of one layer and two layer techniques for colorectal anastomosis. Br J Surg 1975; 62:135-140.
Goligher JC, Lee PW, Simpkins KC, Lintott DJ: A controlled comparison one- and two-layer techniques of suture for high and low colorectal anastomoses. Br J Surg 1977; 64:609-614.
Ordorica-Flores RM, Bracho-Blanchet E, Nieto-Zermeno J, Reyes-Retana R, Tovilla-Mercado JM, Leon-Villanueva V, Varela-Fascinetto G: Intestinal anastomosis in children: a comparative study between two different techniques. J Pediatr Surg 1998; 33:1757-1759.
Maurya SD, Gupta HC, Tiwari A, Khan SS, Sharma BD: Double layer versus single layer intestinal anastomosis: a clinical trial. Int Surg 1984; 69:339-340.
Askarpour S, Sarmast M, Peyvasteh M, Gholizadeh B. Comparision of single and double layer intestinal anastomosis in Ahwaz educational hospitals. The Internet Journal of Surgery 2009; (23)2.
Shikata S, Yamagishi H, Taji Y, Shimada T, Noguchi Y. Single- versus two- layer intestinal anastomosis: a meta-analysis ofrandomized controlled trials. BMC Surg 2006;6:2
Travers B. Enquiry into the process of nature in repairing injuries of the intestine. 1812; Longman, Rees, Orme, Brown and Green, London.
Lembert A. Memoire sur l
Hautefeuille P. Reflexions sur les sutures digetives: a propos de 570 sutures accomplies depuis 5 ans au surjet monoplan de monobrin. Chirurgie 1976; 102:153
Bailey HR, LaVoo JW, Max E et al Single Layer polypropylene colorectal anastomosis: experience with 100 cases. Dis Colon Rectum 1984; 27:19-23.
Downloads
Published
Issue
Section
License
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (SeeThe Effect of Open Access).
How to Cite
