Abstract
Objective: To compare the outcomes and complications of the single and double-layer anastomosis for large gut pathologies.
Study Design: Comparative prospective study.
Place and Duration of Study: Department of General Surgery, Combined Military Hospital, Rawalpindi, Pakistan, from Feb to Nov 2022.
Methodology: A total of 83 patients, age over 18 years, were incorporated into the study by convenience sampling. All the patients had been diagnosed with a colonic pathology and planned to undergo an elective, large gut anastomosis. Individuals with a prior history of gastrointestinal surgery, medical comorbidities, or deranged clotting profile were excluded. The mean durations of operation and hospital stay were calculated while the incidence of postoperative complications was also assessed. Time until the return of bowel sounds was also noted.
Results: Thirty-eight patients (45.8%) underwent single layer (Group-A), whereas 45 cases (54.2%) were intervened through double layer (Group-B) anastomosis. Mean age for the two groups was 49.0±13.7 and 50.5±16.0 years respectively. Colon and/or rectum cancer were the most prevalent indication for colonic anastomosis (single layer, n=21, 55.3%; double layer, n=23, 51.1%). Single layer anastomosis required 23.1±3.9 minutes in contrast to 28.7±4.2 minutes for its counterpart. Postoperative anastomotic leak was observed in 7(18.4%) cases with single layer and 10(22.2%) cases with double layer surgery. Bowel sounds were reestablished earlier within the former group (2.5±0.7 days) than the latter (2.2±0.6 days).
Conclusion: Both the single- and double-layer anastomosis of large gut are equally safe and efficient.