DOI: http://dx.doi.org/10.18203/2349-2902.isj20213652

A comparative study of suturing technique of intestine between extra-mucosal single layer interrupted and continuous all layers: a single center experience

Manoranjan Kar, Somu Singhal, Bismoy Mondal, Arijit Roy

Abstract


Background: Gastrointestinal anastomosis has been excited interest in our day to day surgical practice. We have compared efficacy, advantages, disadvantages, and complications following intestinal resection-anastomosis using extra-mucosal interrupted single layer suturing or continuous all layer suturing.

Methods: This comparative study included 50 cases (either in emergency or elective undergoing bowel resection and anastomosis), comprising of 2 Groups (25 cases in each Group) between January 2019 to June 2021 at Midnapore Medical College and Hospital. Patients data, operative findings, duration of anastomosis and length of hospital stay, post-operative complications of all patients were followed till discharge.

Results: Our comparative study have shown that- the mean duration for intestinal anastomosis in Group A (extra-mucosal interrupted single layer) and Group B (continuous all layers) were 21.43 minutes and 14.35 respectively. Considering duration of the anastomosis continuous all layers intestinal anastomosis appears to represent in shorter duration, anastomotic leak was noted in 3 patients (6%). Anastomotic leak was observed in 1 patient extra-mucosal interrupted single layer bowel anastomosis whereas two patients in the Group of continuous all layered bowel anastomosis had leak (p value 0.5-not significant) and the mean duration of hospital stay in the Group A and Group B were 7.32 days and 7.92 days respectively. (p value -insignificant).

Conclusions: Duration required to perform a continuous all layer bowl anastomosis is lesser when compared to an extra-mucosal interrupted single layer intestinal anastomosis. There is no significant difference in complications, final outcome and duration of hospital stay between two Groups.


Keywords


Intestinal anastomosis, Single layer extra-mucosal suturing, Continuous suturing, Anastomotic leak, Anastomotic duration

Full Text:

PDF

References


Zinner MJ, Stanle W, Ashley-Maingot’s. Abdominal operations,19th edition, McGraw-Hill’s;1345-90.

Whang EE, Billian A, Hunter D, Pollock RE. small intestine. In: Manual of Surgery. 8th Ed. New York: McGraw-Hill; USA. 2005;27:702-32.

Rullier E, Laurent C, Garrelon J L, Michel P, Saric J, Parneix M. Risk factors for anastomotic leakage after resection of rectal cancer. British Journal of Surgery. 1998;85:355-8.

Murphy JB. History of the Intestinal Anastomosis: Cholecysto-intestinal, gastrointestinal, entero-intestinal anastomosis, and approximation without sutures. Med Rec. 1892;42:665-76.

Khan N, Rahman AU, Sadiq MU. Single layer interrupted sero-submucosal intestinal anstomosis: A prospective study of 100 patients. Journal of medical sciences. 2006;14.

Shikata S, Yamagishi H, Taji Y, Shimada T, Noguchi Y. Single- versus two- layer intestinal anastomosis: a meta- analysis. BMC Surgery. 2006,6:2.

Rajput MJ, Memon AS, Rani A, Khan AI. Use of Single Layer Extra Mucosal Interrupted Suture Intestinal Anastomosis: A prospective analytical study on 72 patients. Jlumhs. 2009;8:1.

Ayub M, Sheikh R, Gangat S, Rehman A. Single layer versus two layer intestinal anastomosis – a prospective study. Pakistan J Surg. 2009;25(3):141-3.

Rajput MJ, Memon AS, Rani M, Sattar A, Khan AI. Use of Single Layer Extra Mucosal Interrupted Suture Intestinal Anastomosis: A prospective analytical study on 72 patients. Jlumhs. 2009;8:1.