Single versus double layer small bowel anastomosis in adults – Randomized controlled study

Abstract

Introduction: Intestinal anastomosis can be done via handsewn, stapler or laparoscopic intracorporeal suturing. Among which handsewn anastomosis is commonly performed because of availability and affordability of suture material. In this study hand sewn single- and double-layer small bowel anastomosis are compared. Objective: To compare single with double layer small bowel anastomosis in terms of time taken for anastomosis, complication, hospital stay and follow up. Material and methods: A prospective comparative study was carried out in Department of Surgery, RMCH, Bareilly, Uttar Pradesh from 01 November 2019 to 31 October 2020. 60 patients were included and equally divided into two groups who underwent elective and emergency small bowel anastomosis. Group A with single layer continuous/interrupted technique with PDS II and Group B with double layer (inner with PDS II and outer with Silk). All data was assessed using either Chi-Square or Unpaired t-test. Results: The mean duration of anastomosis was 18.9±2.09 and 28.3±2.44 minutes in Group A and Group B respectively (p<0.001). In Group A, two patients and in Group B only one patient developed anastomotic leak (P>0.05). Mean duration of hospital stay was 12.73±2.7 and 12.93±1.94 days with Group A and Group B respectively (p>0.05). In Group A, 27 patients and in Group B 29 patients had normal follow up (p>0.05). Conclusion: Single layer small bowel anastomosis was constructed in significant lesser time without significant delay in anastomotic healing, post-operative complications, recovery and hospital stay.